title: Comparative prevalence of superantigen genes in Staphylococcus aureus isolates causing sepsis with and without septic shock.
abstract: BACKGROUND
  Staphylococcus aureus superantigens are associated with the pathogenesis of toxic shock syndrome, but their involvement in septic shock is unknown.
  
  
  METHODS
  We compared the distribution of 11 superantigen genes in S. aureus blood culture isolates obtained from patients with sepsis who did and did not have septic shock (19 and 61 patients, respectively), as well as from patients with suppurative infections (101 patients) and patients with colonization (25 patients).
  
  
  RESULTS
  The prevalence of the enterotoxin A gene (sea) increased significantly with the severity of infection (P<.001), whereas the prevalence of the enterotoxin gene cluster (egc) decreased significantly (P=.009).
  
  
  CONCLUSIONS
  Enterotoxin A (SEA) might play a key role in sea-positive S. aureus sepsis by triggering over-expression of inflammatory mediators associated with shock. Novel treatments targeting superantigens, especially the sea gene, might be beneficial in the treatment of S. aureus sepsis.
authors.affiliation: Centre National de Référence des Staphylocoques, INSERM, Lyon, France. tristan.ferry@univ-lyon1.fr
authors.forename: Tristan
authors.initials: T
authors.lastname: Ferry
authors.forename: Damien
authors.initials: D
authors.lastname: Thomas
authors.forename: Anne-Laure
authors.initials: AL
authors.lastname: Genestier
authors.forename: Michèle
authors.initials: M
authors.lastname: Bes
authors.forename: Gerard
authors.initials: G
authors.lastname: Lina
authors.forename: François
authors.initials: F
authors.lastname: Vandenesch
authors.forename: Jerome
authors.initials: J
authors.lastname: Etienne
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D004768:Enterotoxins / Q000235:genetics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018805:Sepsis / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000235:genetics*; D018089:Superantigens / Q000235:genetics*
chemical_list: D004768:Enterotoxins; D018089:Superantigens