Ferry Tristan, Thomas Damien, Genestier Anne-Laure, Bes Michèle, Lina Gerard, Vandenesch François, Etienne Jerome
Centre National de Référence des Staphylocoques, INSERM, Lyon, France.
Clin Infect Dis. 2005 Sep 15;41(6):771-7. doi: 10.1086/432798. Epub 2005 Aug 4.
Staphylococcus aureus superantigens are associated with the pathogenesis of toxic shock syndrome, but their involvement in septic shock is unknown.
We compared the distribution of 11 superantigen genes in S. aureus blood culture isolates obtained from patients with sepsis who did and did not have septic shock (19 and 61 patients, respectively), as well as from patients with suppurative infections (101 patients) and patients with colonization (25 patients).
The prevalence of the enterotoxin A gene (sea) increased significantly with the severity of infection (P<.001), whereas the prevalence of the enterotoxin gene cluster (egc) decreased significantly (P=.009).
Enterotoxin A (SEA) might play a key role in sea-positive S. aureus sepsis by triggering over-expression of inflammatory mediators associated with shock. Novel treatments targeting superantigens, especially the sea gene, might be beneficial in the treatment of S. aureus sepsis.
金黄色葡萄球菌超抗原与中毒性休克综合征的发病机制相关，但其在脓毒性休克中的作用尚不清楚。
我们比较了从患有和未患有脓毒性休克的脓毒症患者（分别为19例和61例）、化脓性感染患者（101例）以及定植患者（25例）的血培养分离出的金黄色葡萄球菌中11种超抗原基因的分布情况。
肠毒素A基因（sea）的流行率随感染严重程度显著增加（P<0.001），而肠毒素基因簇（egc）的流行率则显著降低（P=0.009）。
肠毒素A（SEA）可能通过触发与休克相关的炎症介质过度表达，在sea阳性金黄色葡萄球菌脓毒症中起关键作用。针对超抗原，尤其是sea基因的新型治疗方法可能对金黄色葡萄球菌脓毒症的治疗有益。
