A Case of Toxic Shock Syndrome Caused by Methicillin-resistant Staphylococcus aureus (MRSA) Following a Burn Injury

Choi, Jee‐Hye; Choi, Jae Hong; Kim, Dae Il; Kim, Jae‐Seok; Choi, Eun Hwa

doi:10.14776/kjpid.2009.16.2.205

Cited by 1 publication

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“…Among patients with menstrual TSS, low or negative concentrations of such antibodies have been reported in 90.5% of patients, and more than 50% of these patients failed to seroconvert within 2 months of acquiring the infection [ 9 ]. TSS caused by S. aureus has rarely been reported; to our knowledge, thus far, only one case of TSS caused by methicillin-resistant S. aureus (MRSA) harboring TSST-1 gene has been reported in a burn patient from Korea [ 13 ]. In addition, the presence of the anti-TSST-1 antibody has not yet been characterized in the Korean population.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Antibody to Toxic Shock Syndrome Toxin-1 in Burn Patients

2015

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BackgroundBurn wounds lack normal barriers that protect against pathogenic bacteria, and burn patients are easily colonized and infected by Staphylococcus aureus. Toxic shock syndrome (TSS) is a rare but fatal disease caused by S. aureus. A lack of detectable antibodies to TSS toxin-1 (TSST-1) in serum indicates susceptibility to TSS.MethodsA total of 207 patients (169 men and 38 women; median age, 42.5 yr) admitted to a burn center in Korea were enrolled in this study. The serum antibody titer to TSST-1 was measured by sandwich ELISA. S. aureus isolates from the patients' nasal swab culture were tested for TSST-1 toxin production by PCR-based detection of the TSST-1 toxin gene.ResultsOne hundred seventy-four (84.1%) patients showed positive results for antibody against TSST-1. All patients aged ≥61 yr (n=28) and <26 months (n=7) were positive for the anti-TSST-1 antibody. S. aureus was isolated from 70 patients (33.8%), and 58.6% of the isolates were methicillin resistant. Seventeen patients were colonized with TSST-1-producing S. aureus. The antibody positivity in these 17 carriers was 88.2%, and the positivity in the non-carriers was 83.7%.ConclusionsMost burn patients had antibody to TSST-1, and nasal colonization with TSST-1-producing S. aureus was associated with positive titers of anti-TSST-1 antibody. Additionally, patients with negative titers of anti-TSST-1 antibody might be susceptible to TSS.

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Section: Introductionmentioning

confidence: 99%