Neonatal toxic shock syndrome-like exanthematous disease (NTED).
The author and colleagues recently discovered an emerging neonatal infectious disease: neonatal toxic shock syndrome-like exanthematous disease (NTED), which is induced by the superantigen toxic shock syndrome toxin-1 (TSST-1), produced by methicillin-resistant Staphylococcus aureus (MRSA). The massively expanded Vbeta2+ T cells were rapidly deleted in the peripheral blood of patients with NTED. A marked depletion of Vbeta2+ T cells was also observed in the peripheral blood before the expansion of these T cells. Anergy is specifically induced in the TSST-1 reactive T cells of patients with NTED. Rapid recovery from NTED without complications is expected to be related to the induction of immunologic tolerance in neonatal patients. Anti-TSST-1 IgG antibody of maternal origin was found to play a protective role in preventing the development of NTED. The number of hospitals that have experience caring for patients with NTED has increased threefold in the past 5 years. Most MRSA isolates from neonatal intensive care units in Japan were found to be a single clone of coagulase type II and to possess TSST-1 and staphylococcal enterotoxin C genes. The timing and increased incidence of NTED suggest the emergence of a new MRSA clone. By recognizing that TSST-1 can induce NTED, healthcare providers may give increased attention to this disease in neonatal wards.
Takahashi
Naoto
N
Department of Pediatrics, Jichi Medical School, Tochigi-ken, Tokyo Women's Medical University, Tokyo, Japan. naoto-t@jichi.ac.jp
D000961:Antilymphocyte Serum / Q000276:immunology; D001427:Bacterial Toxins; D003030:Coagulase / Q000276:immunology; D004768:Enterotoxins / Q000096:biosynthesis / Q000276:immunology*; D005076:Exanthema / Q000175:diagnosis / Q000276:immunology*; D006801:Humans; D007231:Infant, Newborn; D008213:Lymphocyte Activation / Q000276:immunology; D016106:Methicillin Resistance / Q000276:immunology; D011948:Receptors, Antigen, T-Cell / Q000276:immunology; D012772:Shock, Septic / Q000175:diagnosis / Q000276:immunology* / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000276:immunology*; D018089:Superantigens / Q000096:biosynthesis / Q000276:immunology*
D000961:Antilymphocyte Serum; D001427:Bacterial Toxins; D003030:Coagulase; D004768:Enterotoxins; D011948:Receptors, Antigen, T-Cell; D018089:Superantigens; C030107:enterotoxin F, Staphylococcal