Sourek J, Neubauer M, Milácek V, Bergdoll M S, Soucek A
J Hyg Epidemiol Microbiol Immunol. 1984;28(3):279-86.
Two sets of cases of acute diarrhoeal disease caused by plasma-coagulase-positive Staphylococcus aureus strains were studied. Testing the isolates for staphylococcal enterotoxin (SE) production and for lipolytic activity on egg-yolk agar in relation to the clinical course of the illness showed that only part of the cases could be attributed to the effect of SE and that lipolytic activity apparently also played some pathogenetic role. In one of the sets (205 cases) SE production was found in only 29% of the strains isolated; the clinical course in the corresponding patients was typical of staphylococcal enterotoxicosis. Pronounced lipolytic activity without SE production was demonstrated in 30% of strains; here the clinical course was much milder and protracted. Where both factors were produced (21% of cases), the clinical pattern of enterotoxicosis predominated but was somewhat modified. Two outbreaks in one of which SE production and in the other only clear-cut lipolytic activity were found also differed mutually in the clinical respect. The first displayed a picture of typical staphylococcal enterotoxicosis, the second comprised mild diarrhoeal cases with an incubation period of 6-9 hours, diffuse abdominal pain and no fever. Accordingly, the above observations showed a certain positive correlation between the presence of some staphylococcal exoproducts (SE, lipolytic-activity factor) and the clinical course of the disease. This was particularly striking in infants up to 2 years of age. Lipolytic activity seemed to be associated with mild diarrhoeal staphylococcal disease, although the co-participation of (an)other, so far undetermined factor(s), could not be precluded.
对两组由血浆凝固酶阳性金黄色葡萄球菌菌株引起的急性腹泻病病例进行了研究。对分离菌株进行葡萄球菌肠毒素（SE）产生检测以及在蛋黄琼脂上的脂解活性检测，并将其与疾病的临床病程相关联，结果表明只有部分病例可归因于SE的作用，而且脂解活性显然也发挥了一定的致病作用。在其中一组病例（205例）中，仅29%的分离菌株能产生SE；相应患者的临床病程是典型的葡萄球菌肠毒素中毒。30%的菌株表现出明显的脂解活性但不产生SE；在此情况下，临床病程要温和得多且病程迁延。当两种因素都存在时（21%的病例），肠毒素中毒的临床模式占主导但有所改变。在一次暴发中发现了SE产生，而在另一次暴发中仅发现了明显的脂解活性，这两次暴发病例在临床方面也相互不同。第一次呈现出典型的葡萄球菌肠毒素中毒表现，第二次包括轻度腹泻病例，潜伏期为6 - 9小时，弥漫性腹痛且无发热。因此，上述观察结果表明某些葡萄球菌外毒素产物（SE、脂解活性因子）的存在与疾病的临床病程之间存在一定的正相关。这在2岁以下的婴儿中尤为明显。脂解活性似乎与轻度腹泻型葡萄球菌疾病有关，尽管不能排除其他尚未确定的因素的共同参与。
