title: Effect of Merocel vaginal sponge on growth of Staphylococcus aureus and production of toxic shock syndrome-associated toxins.
abstract: BACKGROUND
  Staphylococcus aureus toxic shock syndrome toxin-1 and enterotoxin B are the major causes of toxic shock syndrome. These toxins are produced in sufficient concentrations to produce illness in the presence of certain tampons. This necessitates evaluating tampons, as well as wound dressings for their effects on S. aureus growth and toxin production.
  
  
  METHODS
  In this study, the Merocel vaginal sponge was evaluated both in vitro and in vivo in a rabbit model for effect on S. aureus. The Merocel sponge was tested in Erlenmeyer shake flasks containing growth media and in dialysis tubing immersed in agar growth media for both effect on S. aureus plate counts compared to media alone and effect on production of toxic shock syndrome toxins. The in vivo test included placement of Merocel sponges subcutaneously along the flanks of rabbits with subsequent inoculation with toxic shock syndrome bacteria and evaluation for development of illness and death.
  
  
  RESULTS
  In the two standard in vitro tests, the shake flask and tampon sac, the Merocel sponge inhibited both growth of toxic shock syndrome S. aureus and production of toxic shock syndrome toxin-1 and enterotoxin B. The Merocel sponge also prevented development of toxic shock syndrome in a rabbit model.
  
  
  CONCLUSIONS
  The data suggest the Merocel sponge may reduce the risk of development of toxic shock syndrome in association with its use. These studies may serve as models for evaluation of other products that are intended to be used on mucosal and skin surfaces, for their effect on toxic shock syndrome toxins.
authors.affiliation: Department of Microbiology, University of Minnesota Medical School, Minneapolis 55455, USA.
authors.forename: P M
authors.initials: PM
authors.lastname: Schlievert
mesh_terms: D000818:Animals; D001427:Bacterial Toxins; D003470:Culture Media; D004353:Drug Evaluation, Preclinical; D004768:Enterotoxins / Q000037:antagonists & inhibitors* / Q000096:biosynthesis; D005260:Female; D005557:Formaldehyde / Q000494:pharmacology*; D006490:Hemostatics / Q000494:pharmacology; D011142:Polyvinyl Alcohol / Q000494:pharmacology*; D011817:Rabbits; D012772:Shock, Septic / Q000209:etiology / Q000517:prevention & control*; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000254:growth & development / Q000378:metabolism; D018089:Superantigens; D013630:Tampons, Surgical
chemical_list: D001427:Bacterial Toxins; D003470:Culture Media; D004768:Enterotoxins; D006490:Hemostatics; D018089:Superantigens; C030107:enterotoxin F, Staphylococcal; D005557:Formaldehyde; C027490:polyvinyl alcohol formaldehyde foam; C031818:enterotoxin B, staphylococcal; D011142:Polyvinyl Alcohol