Talkington D F, Schwartz B, Black C M, Todd J K, Elliott J, Breiman R F, Facklam R R
Division of Bacterial and Mycotic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333.
Infect Immun. 1993 Aug;61(8):3369-74. doi: 10.1128/iai.61.8.3369-3374.1993.
Sixty-two invasive Streptococcus pyogenes strains, including 32 strains isolated from patients with streptococcal toxic shock syndrome (STSS), were analyzed for the following phenotypic and genotypic characteristics: M-protein type, serum opacity factor production, protease production, the presence of streptococcal pyrogenic exotoxin (Spe) genes A, B, and C, and in vitro production of SpeA and SpeB. These characteristics were analyzed for possible associations with each other as well as with clinical components of STSS. M-type 1, the most commonly isolated M-type, was significantly associated with protease production. Protease activity was significantly associated with the clinical sign of soft tissue necrosis. M-type 1 and 3 strains from STSS patients were significantly associated with the clinical signs of shock and organ involvement as well as with SpeA production in vitro. Finally, the production of SpeA was significantly associated with the clinical component of shock and organ involvement as well as with rash. These data suggest that STSS does not make up a single syndrome but, rather, that the multiple STSS clinical criteria probably reflect different phenotypic characteristics of individual S. pyogenes isolates.
对62株侵袭性酿脓链球菌菌株进行了以下表型和基因型特征分析，其中包括从链球菌中毒性休克综合征（STSS）患者中分离出的32株菌株：M蛋白类型、血清混浊因子产生、蛋白酶产生、链球菌致热外毒素（Spe）基因A、B和C的存在以及SpeA和SpeB的体外产生。分析了这些特征之间以及与STSS临床成分之间可能存在的关联。最常分离出的M型为M1型，它与蛋白酶产生显著相关。蛋白酶活性与软组织坏死的临床体征显著相关。来自STSS患者的M1型和M3型菌株与休克和器官受累的临床体征以及体外SpeA产生显著相关。最后，SpeA的产生与休克和器官受累的临床成分以及皮疹显著相关。这些数据表明，STSS并非构成单一综合征，而是多种STSS临床标准可能反映了各个酿脓链球菌分离株的不同表型特征。
