Toxic shock syndrome toxin-secreting Staphylococcus aureus in Kawasaki syndrome

Enterotoxin-producing staphylococci cause intestinal inflammation by a combination of direct epithelial cytopathy and superantigen-mediated T-cell activation

“…IVOC specimens were incubated with either one of the patient‐derived staphylococci, or with one of RN6390, a reference wildtype exotoxin‐ but nonenterotoxin‐producing S. aureus (Agr+ Sar+, producing α, β, and δ hemolysins, lipase, protein A, fibronectin‐binding protein),29 RN6911, a nonexotoxin‐producing Agr‐deficient mutant of RN6390,29 or one of two clinically derived strains (courtesy of Dr. Nigel Curtis), an SEB enterotoxin‐producing strain or Staph B, a nonenterotoxin‐producing EDIN‐B exotoxin producing strain 30. In addition to negative controls (no bacteria), an enteropathogenic E. coli (EPEC), E2348/69,28 was used as a positive control.…”

Update on Kawasaki disease: Epidemiology, aetiology and pathogenesis

“…This suggests that the involvement of superantigens is likely to be more complex (and hence difficult to assay) and/or that more than one superantigen can trigger KD. Immunoglobulin M antibody levels are significantly elevated against a variety of superantigens following KD, and one or more superantigen‐producing bacteria are detected in gastrointestinal flora specimens more frequently in KD cases than controls . In a murine model of KD, a superantigen from a lactobacillus cell wall induces a coronary arteritis.…”

The Staphylococcal Enterotoxins

“…KD occurs most commonly in Japanese children and may occur in epidemics. It has been shown that 70% of KD patients harbour SE-producing bacteria (Leung et al, 1993b) and that the pattern of Tcell expansion in these patients suggests superantigen activation (Curtis et al, 1994;Curtis et al, 1995).…”