title: Clinical manifestations of staphylococcal scalded-skin syndrome depend on serotypes of exfoliative toxins.
abstract: We sought a possible correlation between the clinical manifestations of staphylococcal scalded-skin syndrome (SSSS) and the serotype of exfoliative toxins (ET) by PCR screening of the eta and etb genes in Staphylococcus aureus strains isolated from 103 patients with generalized SSSS and 95 patients with bullous impetigo. The eta gene and the etb gene were detected in, respectively, 31 (30%) and 20 (19%) episodes of generalized SSSS and 57 (60%) and 5 (5%) episodes of bullous impetigo. Both genes were detected in 52 (50%) episodes of generalized SSS and 33 (35%) episodes of bullous impetigo. To explain this link between etb and generalized SSSS, we examined the distribution of ETA- and ETB-specific antibodies in the healthy population (n = 175) and found that the anti-ETB antibody titer was lower than the anti-ETA titer. Thus, ETA is associated with bullous impetigo and ETB is associated with generalized SSSS, possibly owing to a lower titer of anti-ETB neutralizing antibodies in the general population.
authors.affiliation: Centre National de Référencedes Staphylocoques, INSERM E0230, IFR62 Laennec, 7 rue Guillaume Paradin, 69372 Lyon cedex 08, France.
authors.forename: Osamu
authors.initials: O
authors.lastname: Yamasaki
authors.forename: Takayuki
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Motoyuki
authors.initials: M
authors.lastname: Sugai
authors.forename: Colette
authors.initials: C
authors.lastname: Chapuis-Cellier
authors.forename: François
authors.initials: F
authors.lastname: Arnaud
authors.forename: François
authors.initials: F
authors.lastname: Vandenesch
authors.forename: Jerome
authors.initials: J
authors.lastname: Etienne
authors.forename: Gerard
authors.initials: G
authors.lastname: Lina
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000907:Antibodies, Bacterial / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D005083:Exfoliatins / Q000145:classification / Q000235:genetics* / Q000276:immunology; D006801:Humans; D007169:Impetigo / Q000453:epidemiology / Q000382:microbiology / Q000503:physiopathology; D007223:Infant; D007231:Infant, Newborn; D016133:Polymerase Chain Reaction; D012703:Serotyping; D013206:Staphylococcal Scalded Skin Syndrome / Q000453:epidemiology / Q000382:microbiology / Q000503:physiopathology*; D013211:Staphylococcus aureus / Q000145:classification / Q000235:genetics / Q000276:immunology / Q000472:pathogenicity*
chemical_list: D000907:Antibodies, Bacterial; D005083:Exfoliatins