No difference in enterotoxin production among Staphylococcus aureus strains isolated from blood compared with strains isolated from healthy carriers

Abstract

The production of enterotoxin A, B, C and D by 196 Staphylococcus aureus strains isolated from blood cultures and 95 strains from nasal carriers was investigated. Half of the bacteraemia strains were from patients who died with or because of their infection, the other half from patients who survived. The nasal strains were selected to match the bacteraemia strains regarding phage types. Overall, 30.6% of the bacteraemia strains and 40.0% of the nasal strains produced enterotoxins; enterotoxins B and C were the toxins produced most frequently in both groups. A similar incidence and pattern of enterotoxin production was found among the bacteraemia strains of S. aureus regardless of acquisition of the infection, the portal of entry, presence or absence of endocarditis and outcome of the infection. Thus, the concept that the enterotoxins play an important role in staphylococcal infections, apart from the diseases caused by the toxins per se such as food poisoning and toxic shock syndrome, cannot be substantiated by the results of the present study.

Evolving superantigens of Staphylococcus aureus

“…Bacterial strains that express SAgs are commonly isolated and are more virulent than nonproducing strains [24]. Approximately 40% of isolates from both healthy carriers and clinical cases are capable of expressing one or more SAg [25,26]. Yet, pathologies that are directly attributable to SAg alone probably occur only under exceptional conditions, despite the likelihood of frequent exposures to toxigenic bacteria.…”

Predictors of Mortality in Staphylococcus aureus Bacteremia

“…However, studies of patients with SAB found similar distributions of enterotoxins (SEA to SEG, SEH, SEI, and TSST-1) in strains isolated from patients who did survive and those who did not survive (48,55,241). Furthermore, a prospective study by Desachy et al found no significant difference (OR, 1.60; 95% CI, 0.34 to 7.59; P ϭ 0.55) between the numbers of enterotoxin-producing strains isolated from surviving (70%; 16/23) and deceased (79%; 11/14) community-onset MSSA-B patients (48).…”

Direktnachweis der Gene für Enterotoxin B und C sowie Toxic Shock Syndrome Toxin-1 ausStaphylococcus aureus-lsolaten mit Hilfe einer Multiplex-PCR . Direct Detection of Genes for Enterotoxin B and C as well as Toxic Shock Syndrome Toxin 1 fromStaphylococcus aureusIsolates with a Multiplex-PCR

“…Verschiedene Studien konnten zeigen, daß zwischen 25%-40% der untersuchten 5. az/7-<?2<,y-Isolate mindestens eines der drei Superantigene-TSST-1, Enterotoxin B oder Enterotoxin C bildeten [11][12][13][14][15][16][17][18]. Damit wird deutlich, daß immerhin jedes vierte S. aureus-Isolat unter bestimmten Bedingungen über eine Superantigenbildung ein TSS auslösen könnte.…”

“…Dies wiederum impliziert, daß es neben Superantigenen auch alternative Ursachen bzw. Mechanismen für einen grampositiven Schock geben muß [11][12][13][14][15][16][17][18].…”