Toxic shock syndrome--the role of the toxin.

From isolates of Staphylococcus aureus derived from patients suffering from toxic shock syndrome a toxin was identified by tests in monkeys and was found to be distinct from the enterotoxin responsible for staphylococcal food poisoning. When purified, this TSS toxin (TSST-1) was characterised and used to generate antibodies in rabbits. Only a small proportion of routine staphylococcal isolates produce TSST-1, though it is clear that this toxin has existed for some years. At the same time, TSST-1 producing staphylococci have been isolated in every continent, yet very few cases of toxic shock syndrome have been recognised in developing countries. Using the purified TSST-1, human sera have been examined for the presence of antibodies. Patients with the disease had either no antibodies, or low titres.