title: Isolation and identification of the group B streptococcal toxin CM101 from infants with sepsis.
abstract: OBJECTIVE
  To determine whether the group B streptococcal (GBS) polysaccharide exotoxin CM101, which induces a complement-activated cytokine-driven inflammatory response, is present in body fluids of infants with GBS disease.
  
  
  METHODS
  With a sandwich enzyme-linked immunosorbent assay, CM101 was measured in plasma, urine, and cerebrospinal fluid from newborn infants who were evaluated for possible infection and from older infants with culture-confirmed GBS disease.
  
  
  RESULTS
  Urine from 11 newborn infants with culture-confirmed early-onset disease contained large amounts of CM101 (1.0 to 5.5 mg/48 h). Plasma concentrations were 62.6 +/- 10.5 microg/mL in these infants and were 69.0 +/- 21.2 microg/mL in 4 older infants with late-onset disease. Plasma CM101 concentrations did not correlate with indexes of illness severity, leukocyte counts, or interleukin-6 or interleukin-8 plasma concentrations. CM101 was present in cerebrospinal fluid of 5 infants with meningitis (8.4 +/- 1.6 microg/mL). CM101 was not found in control samples. CM101 isolated from urine had molecular weight and sugar composition similar to those obtained from GBS culture media, and they both elicited a comparable pathophysiologic response when infused intravenously in lambs.
  
  
  CONCLUSIONS
  CM101 is present in infants with GBS disease, and it appears to be the same as CM101 obtained from GBS culture media.
authors.affiliation: Department of Pediatrics, Vanderbilt University, Nashville, Tennessee 37232, USA.
authors.forename: H W
authors.initials: HW
authors.lastname: Sundell
authors.forename: H
authors.initials: H
authors.lastname: Yan
authors.forename: C E
authors.initials: CE
authors.lastname: Carter
authors.forename: B D
authors.initials: BD
authors.lastname: Wamil
authors.forename: K
authors.initials: K
authors.lastname: Wu
authors.forename: R
authors.initials: R
authors.lastname: Gaddipati
authors.forename: D
authors.initials: D
authors.lastname: Li
authors.forename: C G
authors.initials: CG
authors.lastname: Hellerqvist
mesh_terms: D000818:Animals; D001427:Bacterial Toxins / Q000302:isolation & purification* / Q000378:metabolism; D001826:Body Fluids / Q000378:metabolism; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D007958:Leukocyte Count; D011135:Polysaccharides, Bacterial / Q000302:isolation & purification* / Q000378:metabolism; D018805:Sepsis / Q000378:metabolism / Q000382:microbiology* / Q000503:physiopathology; D012756:Sheep; D013290:Streptococcal Infections / Q000378:metabolism / Q000382:microbiology* / Q000503:physiopathology; D013292:Streptococcus agalactiae / Q000145:classification / Q000378:metabolism
chemical_list: D001427:Bacterial Toxins; D015850:Interleukin-6; D016209:Interleukin-8; D011135:Polysaccharides, Bacterial; C032263:streptococcal polysaccharide type III group B