title: Prevalence of superantigen-secreting bacteria in patients with Kawasaki disease.
abstract: OBJECTIVE
  To assess the prevalence of superantigen secreting bacteria in children with acute Kawasaki disease (KD) relative to control patients.
  
  
  METHODS
  Bacterial cultures were obtained in a blinded fashion from the throat, rectum, and groin of 45 patients with untreated acute KD and 37 febrile control patients from 6 centers in the United States. Cultures were processed for the presence of superantigen-producing bacteria at a central laboratory.
  
  
  RESULTS
  Staphylococci or streptococci that produced superantigens (TSST-1, SEB, SEC, SPEB, SPEC) were isolated from 25 of 45 patients with KD (56%) as compared with 13 of 37 (35%) control patients (P =.078). Because SEB- and SEC-producing Staphylococcus aureus have not been associated with KD and because they do not induce a Vbeta2+ T-lymphocyte response, we analyzed the difference between groups relative to superantigens TSST-1 or SPEB/SPEC production. TSST-1 secreting S aureus or SPEB/SPEC producing group A streptococci were isolated from 20 of 45 (44%) patients with KD compared with 7 of 37 (19%) control patients (P =.019).
  
  
  CONCLUSIONS
  The overall isolation rates of superantigen (TSST-1, SPEB, SPEC, SEB, SEC) producing bacteria between patients with KD and febrile control patients were not statistically significant. However, future studies should further examine the potential role of Vbeta2-stimulatory superantigens (TSST-1 and SPEB/SPEC) in KD.
authors.affiliation: Department of Pediatrics, The National Jewish Medical and Research Center and University of Colorado Health Sciences Center, Denver, USA.
authors.forename: Donald Y M
authors.initials: DY
authors.lastname: Leung
authors.forename: H Cody
authors.initials: HC
authors.lastname: Meissner
authors.forename: Stanford T
authors.initials: ST
authors.lastname: Shulman
authors.forename: Wilbert H
authors.initials: WH
authors.lastname: Mason
authors.forename: Michael A
authors.initials: MA
authors.lastname: Gerber
authors.forename: Mary P
authors.initials: MP
authors.lastname: Glode
authors.forename: Barry L
authors.initials: BL
authors.lastname: Myones
authors.forename: J Gary
authors.initials: JG
authors.lastname: Wheeler
authors.forename: Robin
authors.initials: R
authors.lastname: Ruthazer
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Schlievert
mesh_terms: D000942:Antigens, Bacterial / Q000302:isolation & purification*; D001426:Bacterial Proteins / Q000276:immunology; D001427:Bacterial Toxins; D002135:Calcium-Binding Proteins / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D003546:Cysteine Endopeptidases / Q000276:immunology; D004768:Enterotoxins / Q000276:immunology* / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000382:microbiology*; D011446:Prospective Studies; D013210:Staphylococcus / Q000276:immunology*; D013211:Staphylococcus aureus / Q000276:immunology*; D018089:Superantigens
chemical_list: D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D001427:Bacterial Toxins; D002135:Calcium-Binding Proteins; D004768:Enterotoxins; C094296:Spec1 protein, Strongylocentrotus purpuratus; D018089:Superantigens; C030107:enterotoxin F, Staphylococcal; C031818:enterotoxin B, staphylococcal; C034959:enterotoxin C, staphylococcal; D003546:Cysteine Endopeptidases; C042477:streptopain