Butt H L, Dunstan R H, McGregor N R, Roberts T K, Zerbes M, Klineberg I J
Division of Microbiology and Infectious Disease, Hunter Area Pathology Service, John Hunter Hospital, Newcastle, Australia.
J Med Microbiol. 1998 Jul;47(7):577-84. doi: 10.1099/00222615-47-7-577.
Forty-six patients presenting with chronic orofacial muscle pain and eight age- and sex-matched control subjects were investigated for the carriage prevalence of, and exotoxin production by, coagulase-negative staphylococci (CNS). The eight control subjects were selected from an initial group of 41 subjects on the basis of the absence of musculoskeletal symptoms. There was a significantly higher prevalence and multiple carriage of four or more strains of CNS in patients with chronic muscle pain than in control subjects (23 versus 9 isolates/10 subjects). Two of the 103 CNS isolates from patients with muscle pain and none from the control subjects produced toxic shock syndrome toxin 1 (TSST-1), suggesting that pyrogenic toxins do not significantly contribute to the aetiology of chronic muscle pain. There was a significantly higher prevalence of delta-haemolysin (41 of 114) and 'horse'-haemolysin (56 of 114) production by CNS isolates from patients with chronic muscle pain compared with those from control subjects. None of the control subjects was colonised with CNS that produced significant amount of either delta- or 'horse'-haemolysin, whereas 35 of 44 patients with chronic orofacial muscle pain were colonised with CNS that produced significant amounts of 'horse'-haemolysin, 37 that produced delta-haemolysin and 33 that produced both delta- and horse-haemolysin. This study suggests that membrane-damaging toxins, like delta- and 'horse'-haemolysin, may play a role in the aetiology of chronic orofacial muscle pain.
对46例患有慢性口面部肌肉疼痛的患者以及8名年龄和性别匹配的对照受试者进行了研究，以检测凝固酶阴性葡萄球菌（CNS）的携带率及其外毒素产生情况。这8名对照受试者是从最初的41名受试者中挑选出来的，依据是他们没有肌肉骨骼症状。慢性肌肉疼痛患者中CNS四株及以上菌株的携带率和多重携带情况显著高于对照受试者（每10名受试者中分别为23株和9株分离株）。肌肉疼痛患者的103株CNS分离株中有2株产生中毒性休克综合征毒素1（TSST-1），而对照受试者中无一株产生，这表明致热毒素对慢性肌肉疼痛的病因学贡献不大。与对照受试者相比，慢性肌肉疼痛患者的CNS分离株产生δ-溶血素（114株中有41株）和“马”溶血素（114株中有56株）的发生率显著更高。对照受试者中没有被产生大量δ-或“马”溶血素的CNS定植，而44例慢性口面部肌肉疼痛患者中有35例被产生大量“马”溶血素的CNS定植，37例被产生δ-溶血素的CNS定植，33例被产生δ-和马溶血素的CNS定植。这项研究表明，像δ-溶血素和“马”溶血素这样的膜损伤毒素可能在慢性口面部肌肉疼痛的病因学中起作用。
