Department of Plastic and Reconstructive Surgery, Kanazawa Medical University, Uchinadamachi, Ishikawa, Japan.
Burns. 2010 Aug;36(5):716-21. doi: 10.1016/j.burns.2009.10.004. Epub 2009 Dec 24.
Children with burns have a greater risk of developing toxic shock syndrome (TSS) than adults. This risk is thought to be associated with colonisation by toxic shock syndrome toxin-1 (TSST-1)-producing Staphylococcus aureus in children with insufficient antibody titers. The diagnosis of TSS is difficult because, in the early stages, its signs and symptoms resemble those of other common childhood illnesses such as scarlet fever. If the condition is not treated promptly, the mortality rate is high. This study was designed to determine the titers of TSST-1 serum antibody in Japanese children, in order to prevent TSS and facilitate its early diagnosis. Between May 2006 and May 2007, we studied 119 patients who were treated in the Department of Plastic and Reconstructive Surgery of Kanazawa Medical University Hospital. An enzyme-linked immunosorbent assay (ELISA) was used to test the level of the IgG antibody to TSST-1 in the patients' serum samples. The percentage of cases testing for TSST-1 antibody in the patients under 6 months old was 78.6%, and it was lowest (21.3%) in the age group from 6 to 12 months old. The group of patients older than 41 years showed the highest rate of positivity (100.0%) for TSST-1 antibody. Higher titers of TSST-1 antibody were found within the first 6 months after birth, and lower titers were found between 6 months and 2 years old. The titers began to increase again after age three. The high morbidity of TSS in children around 2 years of age was proven to be related to changes in the titers of TSST-1 antibody. Infants under 6 months old are protected from TSS because of the high level of TSST-1 antibody they receive from their mother. Children are at risk of developing staphylococcal toxic shock syndrome when their immune system is immature and they have no protective circulating anti-TSS antibodies.
儿童比成人更容易患上中毒性休克综合征（TSS）。这种风险被认为与儿童体内产生毒性休克综合征毒素-1（TSST-1）的金黄色葡萄球菌定植有关，而这些儿童的抗体滴度不足。由于 TSS 的早期症状与猩红热等其他常见儿童疾病相似，因此其诊断较为困难。如果不及时治疗，死亡率很高。本研究旨在确定日本儿童 TSST-1 血清抗体滴度，以预防 TSS 并有助于早期诊断。2006 年 5 月至 2007 年 5 月，我们研究了在金泽医科大学医院整形外科接受治疗的 119 名患者。采用酶联免疫吸附试验（ELISA）检测患者血清样本中 TSST-1 IgG 抗体水平。6 个月以下患者检测 TSST-1 抗体的比例为 78.6%，6 至 12 个月龄组最低（21.3%）。41 岁以上的患者组对 TSST-1 抗体的阳性率最高（100.0%）。出生后 6 个月内发现 TSST-1 抗体的滴度较高，6 至 2 岁时发现滴度较低。3 岁后，滴度开始再次升高。2 岁左右儿童 TSS 的高发病率与 TSST-1 抗体滴度的变化有关。6 个月以下的婴儿因从母亲那里获得高水平的 TSST-1 抗体而免受 TSS 的侵害。当儿童的免疫系统不成熟且没有保护性的循环抗 TSS 抗体时，他们有患葡萄球菌中毒性休克综合征的风险。
