Prevalence of superantigen-secreting bacteria in patients with Kawasaki disease.
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.
Leung
Donald Y M
DY
Department of Pediatrics, The National Jewish Medical and Research Center and University of Colorado Health Sciences Center, Denver, USA.
Meissner
H Cody
HC
Shulman
Stanford T
ST
Mason
Wilbert H
WH
Gerber
Michael A
MA
Glode
Mary P
MP
Myones
Barry L
BL
Wheeler
J Gary
JG
Ruthazer
Robin
R
Schlievert
Patrick M
PM
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
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