Toxin Involvement in Staphylococcal Scalded Skin Syndrome

Lina, Gérard; Gillet, Yves; Vandenesch, François; Jones, Mark; Floret, D.; Étienne, Jérôme

doi:10.1086/516129

Cited by 99 publications

(82 citation statements)

References 40 publications

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“…As expected, given the well-known superantigenic activity of TSST-1, there were six cases of scarlet fever and two cases of toxic shock syndrome (30,34). More surprisingly, 11 (69%) of the tstpositive isolates were recovered from patients with SSTIs.…”

Section: Discussionsupporting

confidence: 70%

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Toxin Profiling of Staphylococcus aureus Strains Involved in Varicella Superinfection

et al. 2010

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The most common complications of varicella are bacterial skin and soft tissue infections, generally due to Staphylococcus aureus and group A beta-hemolytic streptococci. The aim of this study was to characterize the toxin and antibiotic resistance profiles of S. aureus isolates involved in varicella complications. Between 2002 and 2007, the French Reference Centre for Staphylococci collected 58 S. aureus isolates involved in varicella superinfection. All the isolates were characterized by screening for 12 toxin genes, agr typing, and mecA gene detection; some isolates were also studied by spa typing, multilocus sequence typing (MLST), and resistance profiling. A major toxin gene was detected in 53% (31/58) of the isolates (genes for exfoliative toxins A and B, 17.2%; Panton-Valentine leukocidin gene, 8.6%; toxic shock syndrome toxin 1 gene, 27.6%). Most clinical manifestations were directly compatible with the classical activity of these toxins. Nineteen isolates (33%) were resistant to methicillin, and 12 of these isolates belonged to an emerging agr-2, ST5 clone that harbors the toxic shock syndrome toxin 1 gene. These data should be considered in the management and treatment of patients with varicella complicated by S. aureus superinfection. Antibiotics that decrease toxin production, such as clindamycin, may provide benefit, and their efficacy against bacterial superinfections in children with varicella should be studied.

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Section: Discussionsupporting

confidence: 70%

“…The corresponding patients' clinical manifestations (SSSS and bullous impetigo in seven and three cases, respectively) were directly compatible with classical toxin activity (2,14,30,38).…”

Section: Discussionmentioning

confidence: 70%

Toxin Profiling of Staphylococcus aureus Strains Involved in Varicella Superinfection

et al. 2010

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“…The "gold standard" identification method initially was the intradermal injection of culture supernatants into newborn mice (12,19). Electrically assisted or nonassisted Ouchterlony tests can also be used to assess the distributions of ETA-and ETB-producing isolates (6,14,23,24).…”

Section: Discussionmentioning

confidence: 99%

Sensitive and Specific Detection of Staphylococcal Epidermolysins A and B in Broth Cultures by Flow Cytometry-Assisted Multiplex Immunoassay

et al. 2005

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Two of the most common bacterial skin infections of young infants and children are bullous impetigo due to Staphylococcus aureus and its more acute form, staphylococcal scalded skin syndrome. Epidermolysin A (ETA), ETB and, possibly, ETD are responsible for these diseases, which may appear as epidemics in pediatric patients. We tested the reliability of a flow cytometry-assisted multiplex immunoassay (Bio-Plex system) for the detection of ETA and ETB. The Bio-Plex system was found to be highly specific and highly sensitive for toxin concentrations of between 2 and 80,000 pg/ml. The results of this assay were 100% identical to the results of a PCR-based method. We demonstrated that this test did not generate any cross-reactions with ETD-producing isolates. The level of detection of ETB by this test differed according to culture conditions and from isolate to isolate; these results must be taken into account for diagnostic purposes.Impetigo accounts for 10% of bacterial skin infections in neonates and young children. About 30% of children with impetigo develop bullous impetigo due to Staphyloccocus aureus (15). Children 7 years old and younger, adults with renal failure, and immunosuppressed adults may develop a generalized form of bullous impetigo called staphylococcal scalded skin syndrome. These two diseases are caused by strains of S. aureus that produce exfoliative toxins (ETs) or epidermolysins (epidermolysin A [ETA] and ETB). Three epidermolysins have been characterized: these include ETA (2), ETB (13), and ETD (30). These toxins are able to split the superficial epidermis by cleaving the desmosomes of the granular cell layer. This splitting exposes patients to secondary infections by opportunistic pathogens (15). ETs are serine proteases that specifically target and cleave Dsg1 (1). Dsg1 is a member of the desmosomal cadherin family, which includes desmogleins and desmocollins. These molecules are essential for the proper functioning of desmosomes, which maintain the integrity of epithelial tissues. ETs cleave Dsg1 in one of its calcium-binding domains. The three toxins hydrolyze the peptide bond after the glutamic acid at position 381, which forms part of a specific sequence located between extracellular domains 3 and 4.Samples from infected patients are frequently sent to laboratories for analysis, and the detection of epidermolysins is essential to limit the risks of colonization or spreading in pediatric hospital departments.A flow cytometry-assisted multiplex particle-based immunoassay (Bio-Plex system; Bio-Rad, Hercules, Calif.) has been designed and may be used to characterize bacterial compounds and toxins (9, 22). The Bio-Plex technology (8) consists of a particle counter and two laser beams (hardware) as well as software that allows the simultaneous discrimination of beads of different colors and the recording of phycoerythrin-generated fluorescence associated with the beads. One hundred different colors can be distinguished, making it theoretically possible to quantify 100 proteins or ligands si...

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“…127 Small flaccid bullae are formed and filled with fluid that varies from clear, cloudy, opaque, or purulent to white or yellow pus. 128 These bullae rupture and heal, leaving a yellow-brown crust and a nontender lesion. 129 Fluid obtained from these bullae is found to contain S. aureus.…”

Section: Desmogleinmentioning

confidence: 99%

Desmosome assembly, homeostasis, and desmosomal disease

Cirillo¹

2016

CHC

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Cell-cell adhesion is involved in all aspects of tissue behavior in multicellular organisms, from tissue morphogenesis (regulation of cell shape, apoptosis, cell movement, and development of complex structures) to aging and disease. A major player in the dynamic regulation of intercellular contacts is the desmosome. Knowledge of the desmosome has evolved over 150 years from the notion of a static, punctuate, adhesive barrier structure to one of the finely tuned multifunctional complexes involved in the regulation of numerous and diverse aspects of keratinocyte physiology and disease. In this context, nondesmosomal regulatory molecules have been acquiring increasing importance in the study of desmosome homeostasis and have become part of the extended desmosomal interactome named "desmo-adhesome". Among these associated molecules, kinases are the prominent regulators of both desmosome remodeling and acquisition of hyperadhesion, two novel concepts in cell-cell adhesion. Spatiotemporal changes in the expression and regulation of desmosomal proteins also underlie a number of genetic, infectious, autoimmune, and malignant conditions. In addition to offering a systems-level view of the molecular composition of desmosomes, we also discuss the mechanisms that regulate, and disrupt, desmosome homeostasis.

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Toxin Involvement in Staphylococcal Scalded Skin Syndrome

Cited by 99 publications

References 40 publications

Toxin Profiling of Staphylococcus aureus Strains Involved in Varicella Superinfection

Toxin Profiling of Staphylococcus aureus Strains Involved in Varicella Superinfection

Sensitive and Specific Detection of Staphylococcal Epidermolysins A and B in Broth Cultures by Flow Cytometry-Assisted Multiplex Immunoassay

Desmosome assembly, homeostasis, and desmosomal disease

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