Article in Japanese

Exotoxin production profile of Staphylococcus aureus and types of infections

Yoshiaki CHO¹⁾, Kahoru, FUKUOKA¹⁾, Takayuki YAMANAKA¹⁾, Takemi MURAI¹⁾, Mihoko FURUICHI¹⁾, Yuta AIZAWA¹⁾, Kenta ITO²⁾, Takayo SHOJI³⁾, Yuho HORIKOSHI¹⁾

Staphylococcus aureus, a common pathogenic bacterium, produces various exotoxins related to virulence. Toxic shock syndrome toxin-1 (TSST-1) and staphylococcal enterotoxin (SE), which act on T-lymphocytes as super antigens, cause toxin-mediated diseases and extreme allergic reactions, while exfoliative toxin (ET) is responsible for staphylococcal scalded skin syndrome (SSSS), a condition effecting the epidermis. Although staphylococcal toxins are known for their pathogenicity, studies on the relationship of these toxins to clinical diseases among children are limited in Japan. The aim of this study was to examine the relationship of clinical diseases to exotoxin-producing S. aureus in children at Tokyo Metropolitan Children's Medical Center seen between September 2010 and March 2016. Methicillin-resistant S. aureus comprised half of the 230 cases reviewed. Infections of the skin and soft tissue, blood stream, and bone-joints occurred in 126, 49 and 32 cases, respectively. Among these, 62.2% of isolates were positive for at least one staphylococcal exotoxin. SE, TSST-1, and ET were detected in 46.1%, 26.5% and 13.5% of the cases, respectively. The SE type A-producing strain was found 31.3% of bone-joint infections. ET type A and B-producing strains occurred in 4.8% and 19.8% of skin and soft tissue infections, respectively. Notably, all 31 ET-producing strains caused skin and soft tissue infections. Our finding indicated that staphylococcal exotoxins were associated with specific diseases in children.

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1) Division of Infectious Diseases, Department of Pediatrics, Tokyo Metropolitan
Children's Medical Center
2) Division of General Pediatrics, Department of General Pediatrics, Aichi Children's Health and Medical Center
3) Division of Pediatric Infectious Diseases, Shizuoka Children's Hospital

Key words
Received	December 5, 2016
Accepted	March 16, 2017

29 (2)：141─147,2017