Comparative prevalence of superantigen genes in Staphylococcus aureus isolates causing sepsis with and without septic shock.
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.
Ferry
Tristan
T
Centre National de Référence des Staphylocoques, INSERM, Lyon, France. tristan.ferry@univ-lyon1.fr
Thomas
Damien
D
Genestier
Anne-Laure
AL
Bes
Michèle
M
Lina
Gerard
G
Vandenesch
François
F
Etienne
Jerome
J
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*
D004768:Enterotoxins; D018089:Superantigens