[Cases of menstrual toxic shock syndrome in the Czech Republic in 1997-2011].
OBJECTIVE
To determine toxigenicity and other basic characteristics of 47 strains of Staphylococcus aureus referred to the National Reference Laboratory for Staphylococci (NRL) as suspected causative agents of menstrual toxic shock syndrome (MTSS).


METHODS
S. aureus strains were collected from 11 administrative regions of the Czech Republic in 1997-2011. The diagnosis was based on phenotypic (reverse latex agglutination test) and genotypic (polymerase chain reaction) methods.


RESULTS
Forty-four S. aureus strains were producers of toxic shock syndrome toxin 1 (TSST-1), either alone or in combination with staphylococcal enterotoxin. Three strains only produced enterotoxin (B, C, and H).


CONCLUSIONS
MTSS is a serious multisystem disease. In this study, MTSS often had a severe course requiring intensive care. All MTSS patients used vaginal tampons that had been identified in the literature as a risk factor for MTSS. The case of MTSS in a 36-year-old woman caused by an enterotoxin H positive strain of S. aureus is probably the first to be reported in the world.
NRL pro stafylokoky, SZU Centrum epidemiologie a mikrobiologie, Praha. petrasi@szu.cz
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Machová
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Rysková
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Prásil
D000293:Adolescent; D000328:Adult; D001427:Bacterial Toxins / Q000096:biosynthesis*; D018153:Czech Republic / Q000453:epidemiology; D004768:Enterotoxins / Q000096:biosynthesis*; D005260:Female; D006801:Humans; D052576:Menstrual Hygiene Products / Q000382:microbiology; D008598:Menstruation; D012772:Shock, Septic / Q000453:epidemiology / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000145:classification / Q000378:metabolism*; D018089:Superantigens / Q000096:biosynthesis*; D055815:Young Adult
D001427:Bacterial Toxins; D004768:Enterotoxins; D018089:Superantigens; C030107:enterotoxin F, Staphylococcal