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Magnesium and the pathogenesis of toxic shock syndrome

E H Kass1

  • 1Channing Laboratory, Department of Medicine, Harvard Medical School, Boston, Massachusetts 02115.

Reviews of Infectious Diseases
|January 1, 1989
PubMed

Insights

Magnesium deficiency in tampons may trigger toxic shock syndrome toxin 1 production by Staphylococcus aureus. Regulating tampon magnesium content could lead to safer products, preventing this toxin

Area of Science:

  • Microbiology
  • Toxicology
  • Biochemistry

Background:

  • Toxic shock syndrome (TSS) is linked to Staphylococcus aureus toxin production.
  • Menstrually related TSS has been associated with tampon use.
  • Staphylococcus aureus produces toxic shock syndrome toxin 1 (TSST-1).

Purpose of the Study:

  • To investigate the role of magnesium (Mg++) deficiency in TSST-1 production.
  • To explain the pathogenesis of menstrually related TSS.
  • To identify factors influencing experimental reproduction of TSST-1 overproduction.

Main Methods:

  • Culturing Staphylococcus aureus in magnesium-deficient media.
  • Investigating variables such as inoculum size and washing.
  • Assessing toxin production after sufficient incubation periods.

Main Results:

  • Excess TSST-1 production by Staphylococcus aureus occurs in magnesium-deficient environments.
  • Tampon absorbency, correlating with Mg++ absorption, may act as a surrogate for magnesium deficiency.
  • Experimental pitfalls affecting TSST-1 production were identified and addressed.

Conclusions:

  • Magnesium deficiency is a key factor in TSST-1 overproduction by Staphylococcus aureus.
  • Tampon-associated Mg++ depletion offers a plausible explanation for menstrually related TSS.
  • Developing tampons with regulated magnesium content may enhance safety by preventing magnesium-deficient conditions.

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