A total of 429 different Staphylococcus aureus isolates encompassing 219 blood isolates and 210 isolates taken from anterior nares were systematically searched by two multiplex PCR-DNA enzyme immunoassays (PCR-DEIA) for exfoliative toxin (ET) genes eta and etb, as well as for the classical members of the pyrogenic toxin superantigen (PTSAg) gene family comprising the staphylococcal enterotoxin (SE) genes sea-see and the toxic shock syndrome toxin 1 gene tst. In addition, a third PCR-DEIA was established to investigate the possession of four recently described SE genes, viz. seg-sej. The most frequent PTSAg/ET genes amplified were seg and sei, which were found strictly in combination in 55.0% of the S. aureus isolates tested. Other frequently detected toxin genes were tst (20.3%), sea (15.9%), and sec (11.2%). Only five isolates harbored ET genes. Regarding the origin of the S. aureus isolates, a significant difference (P ؍ 0.037) was found for the possession of the sed/sej gene combination (10.5% of blood isolates versus 3.3% of nasal strains). Overall, about half of S. aureus isolates tested harbored genes of the classical members of the PTSAg family and ETs (50.8%), whereas 73.0% of S. aureus isolates were toxin gene positive if the recently described SE genes were included. This notable higher prevalence indicates that the possession of PTSAg genes in particular seems to be a habitual feature of S. aureus. Moreover, mainly due to the fixed combinations of seg plus sei, as well as sed plus sej, the possession of multiple PTSAg genes (62.9%) is more frequent than assumed so far.Staphylococcus aureus, which has its ecologic niche in the anterior nares, has been shown to cause a variety of infectious diseases ranging from superficial skin infections to severe systemic infections including toxin-mediated diseases (23). By virtue of exfoliative toxins (ETs) and pyrogenic toxin superantigens (PTSAgs) comprising toxic shock syndrome toxin 1 (TSST-1) and the staphylococcal enterotoxins (SEs), S. aureus causes the staphylococcal scalded-skin syndrome (SSSS), the staphylococcal toxic shock syndrome (TSS), and staphylococcal food poisoning (SFP) (3, 7). Besides their specific toxic properties, the members of the PTSAg family share several structural features and biological characteristics, such as pyrogenicity, superantigenicity, and the ability to enhance the susceptibility to endotoxin shock (20,36).In addition to the classical five major antigenic types of SEs (SEA, SEB, SEC, SED, and SEE) (11), four additional SEs (SEG, SEH, SEI, SEJ) have been reported, and their corresponding genes have been described (30,34,42). For SEC and SEG, several subtypes have been characterized (1, 24). Most recently, the "alphabet" of the SE family was expanded by the detection of further genes (sek, sel, sem, and seo) encoding enterotoxin homologues (18,21,31).In previous studies, the prevalence of classical-toxin-producing S. aureus strains has been investigated by conventional methods based on immunological procedures measuring the t...