Staphylococcus aureus causes a variety of infectious diseases ranging from superficial skin infections to severe, toxin-mediated systemic infections. S. aureus produces many extracellular products, including toxins that affect host cell function or morphology. Virulence toxins are the major factors of staphylococcal infections. In the past years, we designed a study to correlate the clinical syndromes of staphylococcal toxic syndrome (STSS) and staphylococcal scalded skin syndrome (SSSS) in children infected or colonized with S. aureus strains positive for genes encoding for toxins, virulence factors, and antimicrobial resistance. In that study, we demonstrate that S. aureus harboring the pvl and seb genes are closely associated with STSS in previously healthy children. The fnbA and etb genes were expressed with a high frequency among isolates from the STSS and SSSS groups. Besides, most of the isolates were community-associated methicillin-resistant S. aureus that were highly resistant to macrolides but susceptible to trimethoprim-sulfamethoxazole. Additional studies are needed to determine the expression of toxins in strains carrying virulence genes for other categories of complicated S. aureus infection in children. Early detection of these strains in the community, measures to control their spread, and development of drugs that block the virulence factors will be very important to prevent outbreaks of such severe, toxin-mediated infections. And more studies are needed to determine the efficacy of trimethoprim-sulfamethoxazole in children with these complicated infections.
1. Chi CY, Wang SM, Lin CC, Wang HC, Wang JR, Su IJ, Liu CC. Clinical Features of Children Infected With Different Strains of Influenza B in Southern Taiwan. Pediatr Infect Dis J. 2008 Jul;27(7):640-645.
2. Chi CY, Lauderdale TL, Wang SM, Wu JM, Yang YJ, Liu CC. Health care-associated endocarditis caused by Staphylococcus aureus with reduced susceptibility to vancomycin. J Clin Microbiol. 2008 Feb;46(2):810-3.
3. Chi CY, Wang SM, Lin HC, Liu CC. Complications of varicella infection in children in southern Taiwan. J Microbiol Immunol Infect. 2006 Oct;39(5):402-7.
4. Chi CY, Wang SM, Lin HC, Liu CC. A clinical and microbiological comparison of Staphylococcus aureus toxic shock and scalded skin syndromes in children. Clin Infect Dis. 2006 Jan 15;42(2):181-5.
5. Chi CY, Tseng FC, Liu DP, Chang YW, Wu HC, Huang YF, Hwang KP, Hsu YW, Wang SM, Liu CC, Wang JR, Wu HS, Yang CF and Su IJ. Investigations of the Laboratory Isolates of Oral Poliovirus Strains Between 2000 and 2005 inSouthern Taiwan. (submitted)
6. Tseng FC, Huang HC, Chi CY, Lin TL, Liu CC, Jian JW, Hsu LC, Wu HS, Yang JY, Chang YW, Wang HC, Hsu YW, Su IJ, Wang JR; CDC-Taiwan Virology Reference Laboratories and Sentinel Physician Network. Epidemiological survey of enterovirus infections occurring in Taiwan between 2000 and 2005: analysis of sentinel physician surveillance data. Med Virol. 2007 Dec;79(12):1850-60.
7. Huang MC, Wang SM, Hsu YW, Lin HC, Chi CY, Liu CC. Long-term cognitive and motor deficits after enterovirus 71 brainstem encephalitis in children. Pediatrics. 2006 Dec;118(6):e1785-8.
8. Wang SM, Yang YJ, Chen JS, Lin HC, Chi CY, Liu CC. Invasive fungal infections in pediatric patients with leukemia: emphasis on pulmonary and dermatological manifestations. Acta Paediatr Taiwan. 2005 May-Jun;46(3):149-55.