title: Failure of viridans group streptococci causing bacteremia in pediatric oncology patients to express superantigens.
abstract: Group A Streptococcus pyogenes causes a distinctive clinical disorder, streptococcal toxic shock syndrome, mediated by superantigenic bacterial exotoxins. Oncology patients with viridans group streptococcal sepsis frequently present with a streptococcal toxic shocklike syndrome of unclear pathogenesis. Viridans group streptococci isolated from pediatric oncology patients with streptococcal toxic shocklike illnesses do not possess homologs of known superantigen genes. Supernatants from cultures of these bacteria also fail to stimulate T-cell proliferation, suggesting these bacteria do not commonly elaborate superantigens. Adjunctive treatment with intravenous immunoglobulin, which is advantageous in streptococcal toxic shock syndrome, may not benefit these patients.
authors.affiliation: Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN 38105, USA.
authors.forename: Esobe F
authors.initials: EF
authors.lastname: Ohuoba
authors.forename: Rita G
authors.initials: RG
authors.lastname: Kansal
authors.forename: Randall T
authors.initials: RT
authors.lastname: Hayden
authors.forename: Malak
authors.initials: M
authors.lastname: Kotb
authors.forename: Elisabeth E
authors.initials: EE
authors.lastname: Adderson
mesh_terms: D000293:Adolescent; D016470:Bacteremia / Q000276:immunology* / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000382:microbiology*; D013290:Streptococcal Infections / Q000276:immunology* / Q000378:metabolism; D018089:Superantigens / Q000096:biosynthesis*; D034363:Viridans Streptococci / Q000276:immunology* / Q000378:metabolism
chemical_list: D018089:Superantigens