Low incidence of toxic shock syndrome in children with staphylococcal infection.
Children have frequent staphylococcal infections, and many lack antibody to TSST-1, a toxin associated with the toxic shock syndrome (TSS). To determine why there have been no nonmenstrual cases of TSS reported in children in Utah, the authors tested S. aureus isolated from children for TSST-1 by radial immunodiffusion and sera from other hospitalized children by radioimmunoassay for antibody to TSST-1. TSST-1 was produced by 25% of S. aureus. Fifty-two children had infections with toxin producing strains. None had TSS. The prevalence of presumably protective levels of antibody (greater than or equal to 1:100) was high in newborns (80%), declined until age 2 years and then gradually increased with age. Therefore, there may have been about 20 children with toxigenic infection who lacked protective antibody but did not show the usual features of TSS. We conclude that the rarity of TSS in children is not caused by misdiagnosis, underreporting, or the absence of toxigenic strains or susceptible patients. Additional factors, such as local conditions or duration of carriage, may influence the clinical presentation of infection with TSST-1 producing staphylococci.
Department of Medicine, LDS Hospital 84143.
J A
JA
Jacobson
E M
EM
Kasworm
R F
RF
Reiser
M S
MS
Bergdoll
D000907:Antibodies, Bacterial / Q000032:analysis*; D001427:Bacterial Toxins; D002648:Child; D002675:Child, Preschool; D004768:Enterotoxins / Q000276:immunology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D012772:Shock, Septic / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology; D013203:Staphylococcal Infections / Q000276:immunology*; D013211:Staphylococcus aureus / Q000276:immunology*; D018089:Superantigens
D000907:Antibodies, Bacterial; D001427:Bacterial Toxins; D004768:Enterotoxins; D018089:Superantigens; C030107:enterotoxin F, Staphylococcal