Summary
The authors investigated the production of toxic shock syndrome toxin-1 (TSST-1) and staphylococcal enterotoxins (SE) by Methicillin-resistantStaphylococcus aureus (MRSA) isolates to clarify the pathogenesis of postoperative MRSA enteritis in patients undergoing gastroenterological surgery. Regarding the percentage of TSST-1-producing strains, there was a significant difference between type II MRSA strains (68.8%) and type IV MRSA strains (4.2%). Among type II strains, all those producing staphylococcal entorotoxin (SE) type C (SEC) also produced TSST-1, although other strains that produced SEB without TSST-1 were commonly isolated. Strains producing SEA were potent producers of SE which was considered to be responsible for enteritis. Therefore, we hypothesized that the strains which produced both SEA and SEC tended to cause enteritis associated with TSS-like symptoms owing to the high titer of these toxins.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Iwai S, Sato T, Kunimatsu M, et al: Countermeasure against postoperative infectious complications in gastroenterological surgery. Shoukaki Geka 1991; 14:265–275. (in Japanese)
Suzuki K, Hori K, Ishihara H, et al: A conclusion for the cause of MRSA enterocolitis: a clinical and experimental study. Nippon Geka Kansenshou Kenkyuu 1990;2:262–266. (in Japanese)
Todd J, Fishaut M, Kapral F, et al: Toxic shock syndrome associated with phage group-1 Staphylococci. Lancet 1978;ii: 1116–1118.
Kapral FA: Epidermal toxin production byStaphylococcus aureus strains from patients with toxic shock syndrome. Ann intern Med 1982;96:972–974.
Bergdoll MS, Schlievert PM: Toxic shock syndrome toxin. Lancet 1984;ii:691–691.
Garbe PL, Arko RJ, Peingold AL, et al:Staphylococcus aureus isolates from patients with non-menstrual toxic shock syndrome. Evidence for additional toxins. J Am Med Assoc 1985:253:2538–2542.
Schlievert PM: Staphylococcal enterotoxin B and toxic shock syndrome toxin-1 are significantly associated with nonmenstrual TSS. Lancet 1986;i: 1149–1150.
Fast DJ, Schlievert PM, Nelson RD: Toxic shock syndrome-associated staphylococcal and streptococcal pyrogenic toxins are potent inducers of tumor necrosis factor production. Infect Immun 1989;57:291–294.
Reiser RF, Robbins RN, Khoe GP: Purification and some physicochemical properties of toxic-shock toxin. Biochemistry 1983;22: 3907–3912.
Fujii Y: On the renewal of the standard method for MIC measurement. Chemotherapy 1981;29:76–79.
Igarashi H, Fujikawa H, Usami H, et al: Purification and characterization ofStaphylococcus aureus FRI 1169 and 587 toxic shock syndrome exotoxins. Infect Immun 1984;44:175–181.
Quimby FW, Nguyen HT: Animal studies of toxic shock syndrome. Crit Rev Microbiol 1985:12:1–44.
Schlievert PM, Shands KN, Dan BB: Identification and characterization of an exotoxin from Staphylococcus aureus associated with toxic shock syndrome. J Infect Dis 1981; 143:509–516.
Beezhold DH, Best GK, Bonventre PF, et al: Synergistic induction of IL-1 by endotoxin and toxic shock syndrome toxin-1 using rat macrophages. Infect Immun 1987;55:2865–2869.
Uchiyama T, Kamagata Y, Yan X-J, et al: Relative strength of the mitogenic and interleukin-2 production-inducing activities of staphylococcal exotoxins presumed to be causative exotoxins of toxic shock syndrome: toxic shock syndrome toxin-1 and enterotoxins A, B and C to murine and human T cells. Clin Exp Immunol 1989;75: 239–244.
Parsonnet J, Gillis ZA, Pier GB: Induction of interleukin-1 by strains ofStaphylococcus aureus from patients with nonmenstrual toxic shock syndrome. J Infect Dis 1986;154:55–63.
Jupin C, Anderson S, Damais C, et al: Toxic shock syndrome toxin 1 as an inducer of human tumor necrosis factors and É’ interferon. J Exp Med 1988;167:752–761.
Soeda K, Kanno H, Isono K, et al: Effect of our system against MRSA infection in gastroenterological surgery. Hukubu Kyuukyuu Shinryou no Shinpo 1990; 10:648–655. (in Japanese)
Ubukata K: Epidemiologic characteristics and mechanisms of resistance of methicillin-resistantStaphylococcus aureus. The Saishin Igaku 1989;44:2499–2509. (in Japanese with English Abstr.)
Takesue Y, Yokoyama T, Kodama T et al: Methicillin-resistant Staphylococcus aureus in nosocomial infection in the surgical ward and operating room. Hiroshima J Med Sci 1989;38:183–186.
Crass BA, Bergdoll MS: Toxin involvement in toxic shock syndrome. J Infect Dis 1986;153:918–926.
Bohach GA, Kreiswirth BN, Novick RP, et al: Analysis of toxic shock syndrome isolates producing staphylococcal enterotoxins B and C, with use of southern hybridization and immunologic assays. Rev Infect Dis 1989; 11:75–82.
Scott DF, Best GK, Kling JM, et al: Passive protection of rabbits infected with toxic shock syndrome-associated strains ofStaphylococcus aureus by monoclonal antibody to toxic shock syndrome toxin 1. Rev Infect Dis 1989;11:214–218.
Fraser JD: High affinity binding of staphylococcal enterotoxins A and B to HLA-DR. Nature (Lond.) 1989;339:221–223.
Mollick JA, Cook RC, Rich RP: Class II MHC molecules are specific receptors for staphylococcal enterotoxin A. Science (Wash. DC) 1989;244:817–820.
Herman A, Croteau G, Sekaly R-P, et al: HLA-DR alle’les differ in their ability to present staphylococcal enterotoxins to T cells. J Exp Med 1990;172:709–717.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Takesue, Y., Yokoyama, T., Kodama, T. et al. Toxin involvement in methicillin-resistant Staphylococcus aureus enteritis in gastroenterological surgery. Gastroenterol Jpn 26, 716–720 (1991). https://doi.org/10.1007/BF02782858
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02782858