Detection of circulating superantigens in an intensive care unit population.
OBJECTIVE
Plasma concentrations of superantigens were measured in an intensive care unit (ICU) population and the relationship of superantigen positive rates with the presence of sepsis was investigated.


METHODS
Plasma samples were collected at least twice a week from 78 patients whose primary diagnoses were abdominal disorders (n = 27), respiratory disorders (n = 11), trauma (n = 10), burns (n = 10), cardiovascular disorders (n = 4), neurological disorders (n = 2), and others (n = 14). Five different species of superantigens, i.e., staphylococcal enterotoxins A, B, and C (SEA, SEB, and SEC), toxic shock syndrome toxin-1 (TSST-1), and streptococcal pyrogenic exotoxin A (SPEA), were measured using an enzyme-linked immunosorbent assay.


RESULTS
Significant levels of plasma superantigens were detected in 16 patients. SEA was found in seven patients, SEB in four patients, SEC in two patients, TSST-1 in six patients, and SPEA in five patients. Superantigen detection rates were 6% (1/17) in patients without systemic inflammatory response syndrome (SIRS), 0% (0/21) in SIRS patients without infection, 31% (5/16) in septic patients without shock, and 42% (10/24) in septic shock patients.


CONCLUSIONS
The presence of superantigens was confirmed in part of the ICU population. The role of superantigens in the pathogenesis of sepsis remains to be determined.
Department of Emergency and Critical Care Medicine, Chiba-Hokuso Hospital, Nippon Medical School, Chiba, Japan.
Kazuaki
K
Azuma
Kaoru
K
Koike
Tatsuho
T
Kobayashi
Toru
T
Mochizuki
Kunihiro
K
Mashiko
Yasuhiro
Y
Yamamoto
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001426:Bacterial Proteins / Q000097:blood*; D001427:Bacterial Toxins / Q000097:blood*; D004768:Enterotoxins / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005098:Exotoxins / Q000097:blood*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008565:Membrane Proteins / Q000097:blood*; D008875:Middle Aged; D018805:Sepsis / Q000097:blood / Q000453:epidemiology*; D012772:Shock, Septic / Q000097:blood; D013211:Staphylococcus aureus / Q000378:metabolism*; D018089:Superantigens / Q000097:blood*
D001426:Bacterial Proteins; D001427:Bacterial Toxins; D004768:Enterotoxins; D005098:Exotoxins; D008565:Membrane Proteins; C117980:SpeA protein, Streptococcus pyogenes; D018089:Superantigens; C030107:enterotoxin F, Staphylococcal