Toxin involvement in toxic shock syndrome.
Cultures for Staphylococcus and sera from 434 individuals with confirmed or probable toxic shock syndrome (TSS) were studied. Three hundred forty-eight (91.6%) of the staphylococcal isolated produced TSS toxin-1 (TSST-1) alone or in combination with one or more staphylococcal enterotoxins. Isolates producing both staphylococcal enterotoxin C and TSST-1 had a higher association with nonmenstrual and fatal cases than did any other toxin combination. The sera of 284 patients with TSS were tested for antibodies to TSST-1, and 234 (82.4%) had no detectable level of antibody compared with 80 (77.7%) of 103 healthy controls having antibody levels of greater than or equal to 1:800. The sera from patients with TSS also had lower levels of antibody to staphylococcal enterotoxins A, B, and C than did the controls, a result indicating that these subjects may have an immunodeficiency that inhibits the production and/or maintenance of antibodies to the staphylococcal enterotoxins and TSST-1.
B A
BA
Crass
M S
MS
Bergdoll
D000293:Adolescent; D000328:Adult; D000907:Antibodies, Bacterial / Q000032:analysis; D001427:Bacterial Toxins; D004768:Enterotoxins / Q000096:biosynthesis* / Q000276:immunology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012772:Shock, Septic / Q000276:immunology / Q000382:microbiology*; D013210:Staphylococcus / Q000276:immunology / Q000302:isolation & purification / Q000378:metabolism*; D013211:Staphylococcus aureus / Q000276:immunology / Q000302:isolation & purification / Q000378:metabolism; D013212:Staphylococcus epidermidis / Q000276:immunology / Q000302:isolation & purification / Q000378:metabolism; D018089:Superantigens
D000907:Antibodies, Bacterial; D001427:Bacterial Toxins; D004768:Enterotoxins; D018089:Superantigens; C030107:enterotoxin F, Staphylococcal; C019368:enterotoxin D, Staphylococcal; C026066:enterotoxin A, Staphylococcal; C031818:enterotoxin B, staphylococcal; C034959:enterotoxin C, staphylococcal