Enterotoxin B Is the Predominant Toxin Involved in Staphylococcal Scarlet Fever in Taiwan

Abstract

This study retrospectively reviewed all pediatric cases of staphylococcal scarlet fever (SSF) that occurred during a 10-year period in a 1400-bed tertiary medical center in northern Taiwan. All 20 cases of SSF occurred in previously healthy individuals. Skin and soft-tissue infections predominated among children from whom Staphylococcus aureus was isolated. Polymerase chain reaction testing was used to detect known staphylococcal toxin genes, and of the isolates studied, most (18 [90%] of 20) contained only the staphylococcal enterotoxin B. One of the other strains was positive for staphylococcal enterotoxin A only, and the last strain was positive for both staphylococcal enterotoxin G and staphylococcal enterotoxin I. Pulsed-field gel electrophoresis identified a small cluster of isolates (6 [30%] of 20) that were genetically related, but these strains came from epidemiologically unrelated patients during a 3-year period.

Strain typing and characterization of virulence genes in clinicalStaphylococcus aureusisolates from Kenya

“…Kenyan isolates bearing SEB typed to CC 8 and CC 152 consistent with previous observations where SEB was identified most often in CC8 isolates in New York [66]. A Taiwanese study identified SEB to be the cause of Staphylococcal scarlet fever [67]. In this study, SEB was detected in MSSA isolates obtained from a burn and from an abscess.…”

Staphylococcal scarlet fever associated with staphylococcal enterotoxin M in an elderly patient

“…aureus encodes numerous toxins, including pore-forming toxins, ETs, and superantigens (Grumann et al, 2014). The identified SSF-associated toxins are primarily superantigens, including SEA-D, SEG, SEI, TSST-1, and rarely, ETA and ETB (Courjon et al, 2013;Jarraud et al, 1999;Lina et al, 1997;Lo et al, 2009;Wang et al, 2004). The isolate from our case was only positive for SEM among the superantigens.…”

“…Staphylococcal scarlet fever (SSF) is characterized by an exanthem without enanthem, bullae, or exfoliation, and it is considered to be a mild form of SSSS or TSS (Courjon et al, 2013;Lo et al, 2009). SSF has never been reported in elderly patients, and an association between SSF and staphylococcal enterotoxin M (SEM) has not been published previously (Courjon et al, 2013;Lina et al, 1997;Lo et al, 2009;Wang et al, 2004;Weisse, 2001). Thus, to our knowledge, we report the first case of an elderly patient with SSF caused by SEM, which was associated with a case of otitis externa.…”

“…The ages of SSF patients from previous case studies ranged from 0.2 months to 13 years (Courjon et al, 2013;Lina et al, 1997;Lo et al, 2009;Wang et al, 2004). Only one study that examined an association between enterotoxins and SSF reported two adult cases (Jarraud et al, 1999).…”

Staphylococcal phosphatidylinositol‐specific phospholipase C potentiates lung injury via complement sensitisation

“…The clinical S. aureus isolates were obtained from the Tri‐Service General Hospital (Lo et al, ; Wang, Lo, Hsu, & Chu, ). Disease‐causing S. aureus strains (S) were isolated from skin wounds resulting from abscesses, bullous impetigo, or carbuncles; some patients suffered from generalised skin rashes excluding streptococcal infection.…”