The absence of evidence of staphylococcal toxin involvement in the pathogenesis of Kawasaki disease.
To detect a causative superantigen and to clarify a possible role for staphylococci in Kawasaki disease (KD), culture supernatants of individual bacterial isolates from 11 acute-stage patients were studied. Toxic shock syndrome toxin-1 (TSST-1) and antibody to TSST-1 and enterotoxins A (SEA), B (SEB), and C (SEC) in acute (mean, day 7) and late convalescent (mean, month 15) sera from 26 patients (12 with coronary artery aneurysms) and 22 age-matched controls were measured. Only 1 of 60 supernatants was mitogenic for human lymphocytes; it was 1 of the 4 Staphylococcus aureus isolates. Mitogenicity was neutralized by sera obtained after administration of intravenous gamma globulin (mean, week 4) but not by late convalescent sera. TSST-1 was detectable in 2 of 26 acute sera and 1 of 22 control sera. No KD but 1 control serum had IgM to TSST-1. IgG seroconversion rates to TSST-1, SEA, SEB, and SEC were 10%, 15%, 21% and 16%, respectively. These data do not support the involvement of toxin-producing staphylococci in KD.
Terai
M
M
Division of Infectious Diseases, Children's Memorial Hospital, Chicago, IL 60614, USA.
Miwa
K
K
Williams
T
T
Kabat
W
W
Fukuyama
M
M
Okajima
Y
Y
Igarashi
H
H
Shulman
S T
ST
D000907:Antibodies, Bacterial / Q000097:blood; D001427:Bacterial Toxins / Q000097:blood*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004768:Enterotoxins / Q000097:blood / Q000276:immunology; D006801:Humans; D007223:Infant; D009080:Mucocutaneous Lymph Node Syndrome / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000276:immunology* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000276:immunology*; D018089:Superantigens / Q000097:blood
D000907:Antibodies, Bacterial; D001427:Bacterial Toxins; D004768:Enterotoxins; D018089:Superantigens; C030107:enterotoxin F, Staphylococcal; C026066:enterotoxin A, Staphylococcal; C031818:enterotoxin B, staphylococcal