Comparative prevalence of superantigen genes in Staphylococcus aureus isolates causing sepsis with and without septic...

Staphylococcus aureus superantigens are associated with the pathogenesis of toxic shock syndrome, but their involvement in septic shock is unknown.

We compared the distribution of 11 superantigen genes in S. aureus blood culture isolates obtained from patients with sepsis who did and did not have septic shock (19 and 61 patients, respectively), as well as from patients with suppurative infections (101 patients) and patients with colonization (25 patients).

The prevalence of the enterotoxin A gene (sea) increased significantly with the severity of infection (P<.001), whereas the prevalence of the enterotoxin gene cluster (egc) decreased significantly (P=.009).

Enterotoxin A (SEA) might play a key role in sea-positive S. aureus sepsis by triggering over-expression of inflammatory mediators associated with shock. Novel treatments targeting superantigens, especially the sea gene, might be beneficial in the treatment of S. aureus sepsis.