Staphylococcal superantigens and toxins are detectable in the serum of adult burn patients.

MedStar author(s):
Citation: Diagnostic Microbiology & Infectious Disease. 79(3):303-7, 2014 Jul.PMID: 24809857Institution: MedStar Washington Hospital CenterDepartment: Surgery/Burn ServicesForm of publication: Journal ArticleMedline article type(s): Journal Article | Research Support, Non-U.S. Gov'tSubject headings: *Bacterial Toxins/an [Analysis] | *Burns/co [Complications] | *Enterotoxins/an [Analysis] | *Hemolysin Proteins/an [Analysis] | *Serum/ch [Chemistry] | *Staphylococcal Infections/pa [Pathology] | *Superantigens/an [Analysis] | Adolescent | Adult | Aged | Aged, 80 and over | Female | Humans | Male | Middle Aged | Staphylococcal Infections/mo [Mortality] | Survival Analysis | Young AdultISSN:
  • 0732-8893
Name of journal: Diagnostic microbiology and infectious diseaseAbstract: Bacterial infection in burn patients is still a devastating contributor to morbidity and mortality. Little is known regarding the presence of staphylococcal toxins in the burn-injured patient. The aim of this study was to characterize the prevalence of several of these toxins and their relationship to clinical metrics and mortality in burn patients. Levels of exotoxins staphylococcal enterotoxin A (SEA), staphylococcal enterotoxin B, toxic shock syndrome toxin 1 (TSST-1), and alpha-hemolysin were assayed from the serum of 207 adult burn patients aged 16-92 years. Clinical, demographic, and microbiological data from these patients were then compared to toxin levels. Staphylococcal exotoxins alpha-hemolysin and SEA were present in 45% and 25% of the population, respectively. Bacterial cultures concomitantly showed a high prevalence of Staphylococcus aureus in 48% of patients, of which 59% were methicillin resistant. Several metrics may be predictive of high toxin concentrations of alpha-hemolysin and TSST-1 and SEA including burn size, length of stay, and bacteremia. Mortality associations indicated that burn size, bacteremia, age, and the presence of alpha-hemolysin and SEA may be predictors of mortality. A high prevalence of staphylococcal toxin alpha-hemolysin and superantigens TSST-1 and SEA can be found in the circulation of the adult burn population. The presence of these toxins may contribute to the morbidity and mortality of the burn patient.Copyright � 2014 Elsevier Inc. All rights reserved.All authors: Amundsen BM, Carney BC, Moffatt LT, Paul DW, Pavlovich AR, Prindeze NJ, Shupp JWDigital Object Identifier: Date added to catalog: 2015-03-17
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Journal Article MedStar Authors Catalog Article Available 24809857

Bacterial infection in burn patients is still a devastating contributor to morbidity and mortality. Little is known regarding the presence of staphylococcal toxins in the burn-injured patient. The aim of this study was to characterize the prevalence of several of these toxins and their relationship to clinical metrics and mortality in burn patients. Levels of exotoxins staphylococcal enterotoxin A (SEA), staphylococcal enterotoxin B, toxic shock syndrome toxin 1 (TSST-1), and alpha-hemolysin were assayed from the serum of 207 adult burn patients aged 16-92 years. Clinical, demographic, and microbiological data from these patients were then compared to toxin levels. Staphylococcal exotoxins alpha-hemolysin and SEA were present in 45% and 25% of the population, respectively. Bacterial cultures concomitantly showed a high prevalence of Staphylococcus aureus in 48% of patients, of which 59% were methicillin resistant. Several metrics may be predictive of high toxin concentrations of alpha-hemolysin and TSST-1 and SEA including burn size, length of stay, and bacteremia. Mortality associations indicated that burn size, bacteremia, age, and the presence of alpha-hemolysin and SEA may be predictors of mortality. A high prevalence of staphylococcal toxin alpha-hemolysin and superantigens TSST-1 and SEA can be found in the circulation of the adult burn population. The presence of these toxins may contribute to the morbidity and mortality of the burn patient.Copyright � 2014 Elsevier Inc. All rights reserved.

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