title: [A case of staphylococcal scalded skin syndrome caused by exfoliative toxin-B producing MRSA].
abstract: We experienced a 6 month-old infant who suffered from staphylococcal scalded skin syndrome (SSSS), whose mother used steroid ointment for the infant's erythematous skin rash for 2 days. On the 3rd day, the infant was admitted to our hospital with fever, erythema on the trunk and extremities, and flaccid blisters and erosions at periorificial areas and the neck. Nikolsky's sign was positive. S. aureus was cultured from the throat, conjunctival inflammatory lesion and exudates. The biological characteristics of the isolates were coagulase type I, enterotoxin-nonproducing, TSST-1-nonproducing, protease pattern: D type, and plasmid profile: 563 kbp. The investigation of exfoliative toxin (ET) revealed negative for ET-A but positive for ET-B, proved by polymerase chain reaction (PCR). The isolated strain of S. aureus was demonstrated to be methicillin-resistant (MRSA), which was further defined to be positive for mec A gene by PCR method. It will be possible for such toxigenic ET-B producing MRSA to gain the dominant status in NICU or closed areas.
authors.affiliation: Department of Pediatrics, Yokohama City University School of Medicine.
authors.forename: S
authors.initials: S
authors.lastname: Yokota
authors.forename: T
authors.initials: T
authors.lastname: Imagawa
authors.forename: S
authors.initials: S
authors.lastname: Katakura
authors.forename: T
authors.initials: T
authors.lastname: Mitsuda
authors.forename: K
authors.initials: K
authors.lastname: Arai
mesh_terms: D001483:Base Sequence; D005083:Exfoliatins / Q000096:biosynthesis*; D006801:Humans; D007223:Infant; D008297:Male; D016106:Methicillin Resistance; D008969:Molecular Sequence Data; D013206:Staphylococcal Scalded Skin Syndrome / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000378:metabolism
chemical_list: D005083:Exfoliatins