Cole R P, Shakespeare P G
Wessex Centre for Plastic and Maxillofacial Surgery, Odstock Hospital, Salisbury, Wiltshire, UK.
Burns. 1990 Jun;16(3):221-4. doi: 10.1016/0305-4179(90)90045-x.
Five patients showing clinical signs resembling the 'toxic shock syndrome' presented over a 4-month period at the Wessex Regional Burns Centre. Toxin-producing isolates of Staphylococcus aureus were made from wound swabs in four of the five patients. Four different phage types producing four different toxins were observed. Seven other patients yielded staphylococci from wound swabs but did not develop the toxic shock syndrome. In three of these latter patients the staphylococcus isolated was toxin producing. Since the syndrome carries a significant mortality risk it is desirable that it is recognized and treated without delay. To this end a simplified set of criteria for the identification of probable toxic shock syndrome cases is proposed. The observations suggest that toxic shock syndrome is more common than previously supposed. The syndrome may show a broad spectrum in its clinical presentation, and involve a wide range of staphylococcal phage types with possible involvement of several different enterotoxins.
在4个月的时间里，有5名表现出类似“中毒性休克综合征”临床症状的患者被送到了韦塞克斯地区烧伤中心。在这5名患者中的4名患者的伤口拭子中分离出了产毒素的金黄色葡萄球菌。观察到4种不同的噬菌体类型产生4种不同的毒素。另外7名患者的伤口拭子中也培养出了葡萄球菌，但并未出现中毒性休克综合征。在这7名患者中的3名患者身上分离出的葡萄球菌是产毒素的。由于该综合征具有很高的死亡风险，因此希望能够及时识别并进行治疗。为此，提出了一套简化的标准，用于识别可能的中毒性休克综合征病例。这些观察结果表明，中毒性休克综合征比以前认为的更为常见。该综合征在临床表现上可能具有广泛的范围，涉及多种葡萄球菌噬菌体类型，并可能涉及几种不同的肠毒素。
