title: Delta toxin activity in coagulase-negative staphylococci from the bowels of neonates.
abstract: Coagulase-negative staphylococci are prominent in stools of neonates in some intensive care units and have been associated with necrotizing enterocolitis. A plausible mediator of bowel damage is delta-like toxin, which is produced in vitro by most coagulase-negative staphylococci, but factors influencing the expression of toxin in the bowel are unknown. We examined 105 coagulase-negative staphylococcus isolates from stools of neonates by using an enzyme-linked immunosorbent assay and detected delta toxin production by 92 isolates (88%). The amount present in 18-h broth cultures varied over 100-fold, from 933 to 125,000 ng/ml. All broths positive by enzyme-linked immunosorbent assay except one caused hemolysis of human erythrocytes. The threshold concentration for consistent cytotoxicity to fibroblasts was greater than or equal to 24,000 ng/ml. Only 56% of Staphylococcus epidermidis isolates were capable of producing this much toxin, and these were more often obtained from premature infants in intensive care than from healthy full-term infants (P = 0.003) and were more often resistant to multiple antibiotics (P less than 0.001). Cultures grown anaerobically seldom caused hemolysis (4 positive of 29 tested; P less than 0.001) because potency of the toxin was decreased (at least ninefold for S. epidermidis isolates). We conclude that only a portion of the fecal coagulase-negative staphylococci tested produced enough delta toxin in vitro to be cytotoxic, that such isolates have accumulated in our intensive care nursery, and that development of toxin-mediated bowel injury may also require a favorable redox potential within the host bowel.
authors.affiliation: Department of Pediatrics, B.C.'s Children's Hospital, Vancouver, Canada.
authors.forename: D W
authors.initials: DW
authors.lastname: Scheifele
authors.forename: G L
authors.initials: GL
authors.lastname: Bjornson
mesh_terms: D000332:Aerobiosis; D000693:Anaerobiosis; D001427:Bacterial Toxins / Q000096:biosynthesis*; D003030:Coagulase / Q000378:metabolism; D004761:Enterocolitis, Pseudomembranous / Q000382:microbiology*; D004797:Enzyme-Linked Immunosorbent Assay; D004917:Erythromycin / Q000494:pharmacology; D005243:Feces / Q000382:microbiology; D005839:Gentamicins / Q000494:pharmacology; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000382:microbiology*; D010068:Oxacillin / Q000494:pharmacology; D013210:Staphylococcus / Q000201:enzymology / Q000378:metabolism*; D013212:Staphylococcus epidermidis / Q000187:drug effects / Q000201:enzymology / Q000378:metabolism
chemical_list: D001427:Bacterial Toxins; D003030:Coagulase; D005839:Gentamicins; C025971:staphylococcal delta toxin; D004917:Erythromycin; D010068:Oxacillin