Toxin involvement in methicillin-resistant Staphylococcus aureus enteritis in gastroenterological surgery.

The authors investigated the production of toxic shock syndrome toxin-1 (TSST-1) and staphylococcal enterotoxins (SE) by Methicillin-resistant Staphylococcus 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.