Integrated BioTherapeutics Inc, Gaithersburg, MD, USA.
J Infect Dis. 2012 Sep 15;206(6):915-23. doi: 10.1093/infdis/jis462. Epub 2012 Jul 17.
Staphylococcus aureus has numerous virulence factors, including exotoxins that may increase the severity of infection. This study was aimed at assessing whether preexisting antibodies to S. aureus toxins are associated with a lower risk of sepsis in adults with S. aureus infection complicated by bacteremia.
We prospectively identified adults with S. aureus infection from 4 hospitals in Baltimore, MD, in 2009–2011. We obtained serum samples from prior to or at presentation of S. aureus bacteremia to measure total immunoglobulin G (IgG) and IgG antibody levels to 11 S. aureus exotoxins. Bacterial isolates were tested for the genes encoding S. aureus exotoxins using polymerase chain reaction (PCR).
One hundred eligible subjects were included and 27 of them developed sepsis. When adjusted for total IgG levels and stratified for the presence of toxin in the infecting isolate as appropriate, the risk of sepsis was significantly lower in those patients with higher levels of IgG against α-hemolysin (Hla), δ-hemolysin (Hld), Panton Valentine leukocidin (PVL), staphylococcal enterotoxin C-1 (SEC-1), and phenol-soluble modulin α3 (PSM-α3).
Our results suggest that higher antibody levels against Hla, Hld, PVL, SEC-1, and PSM-α3 may protect against sepsis in patients with invasive S. aureus infections.
金黄色葡萄球菌有许多毒力因子，包括可能加重感染严重程度的外毒素。本研究旨在评估金黄色葡萄球菌感染患者在发生菌血症的情况下，是否存在针对金黄色葡萄球菌毒素的预先存在的抗体与降低脓毒症风险有关。
我们前瞻性地从马里兰州巴尔的摩的 4 家医院确定了 2009 年至 2011 年期间患有金黄色葡萄球菌感染的成年人。我们在金黄色葡萄球菌菌血症出现之前或出现时获得血清样本，以测量针对 11 种金黄色葡萄球菌外毒素的总 IgG 和 IgG 抗体水平。使用聚合酶链反应 (PCR) 检测细菌分离株中编码金黄色葡萄球菌外毒素的基因。
纳入了 100 名符合条件的患者，其中 27 名患者发生了脓毒症。当调整总 IgG 水平并根据感染分离株中是否存在毒素进行分层时，针对α-溶血素 (Hla)、δ-溶血素 (Hld)、Panton Valentine 白细胞毒素 (PVL)、葡萄球菌肠毒素 C-1 (SEC-1) 和酚可溶性调节素 α3 (PSM-α3) 的 IgG 水平较高的患者发生脓毒症的风险显著降低。
我们的结果表明，针对 Hla、Hld、PVL、SEC-1 和 PSM-α3 的更高抗体水平可能有助于预防侵袭性金黄色葡萄球菌感染患者发生脓毒症。
