Staphylococcus aureus nasal carriage in rheumatoid arthritis: antibody response to toxic shock syndrome toxin-1.
OBJECTIVE
To determine the prevalence of Staphylococcus aureus nasal carriage and to compare antibody responses to two superantigens, staphylococcal toxic shock syndrome toxin-1 (TSST-1) and staphylococcal enterotoxin A (SEA), in rheumatoid arthritis patients and normal subjects.


METHODS
88 rheumatoid arthritis patients and 110 control subjects were cultured for nasal carriage of S aureus; 62 isolates were bacteriophage typed. Twenty five patients and 11 spouses were tested for antibodies to TSST-1, SEA, and sonicate extracts of Bacteroides fragilis and Escherichia coli; 19 patients were HLA-DR typed.


RESULTS
50% of patients and 33% of normal subjects were S aureus carriers. Bacteriophage typing of isolates suggested significant differences between strains isolated from the two groups. Patients showed higher IgG (P = 0.0025) and IgA (P = 0.0372) antibody levels to TSST-1 than normal spouses and these responses were not related to rheumatoid factor titres or HLA-DR type.


CONCLUSIONS
When compared to normals, rheumatoid arthritis patients more often carry S aureus in their nasal vestibule, carry a distinct subpopulation of S aureus strains, and have higher average antibody levels to TSST-1.
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Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, USA.
Hoffman
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood; D001172:Arthritis, Rheumatoid / Q000276:immunology / Q000382:microbiology*; D001427:Bacterial Toxins; D004768:Enterotoxins / Q000276:immunology*; D004926:Escherichia coli / Q000276:immunology; D005260:Female; D006684:HLA-DR Antigens / Q000097:blood / Q000235:genetics; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D009666:Nose / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000276:immunology / Q000302:isolation & purification*; D018089:Superantigens
D000907:Antibodies, Bacterial; D001427:Bacterial Toxins; D004768:Enterotoxins; D006684:HLA-DR Antigens; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D018089:Superantigens; C030107:enterotoxin F, Staphylococcal; C026066:enterotoxin A, Staphylococcal