Abstract
Staphylococcal toxic shock syndrome (TSS) was originally described in menstruating women and linked to TSS toxin 1 (TSST-1)-producing Staphylococcus aureus. Using UK national surveillance data, we ascertained clinical, molecular and superantigenic characteristics of TSS cases. Average annual TSS incidence was 0.07/100,000 population. Patients with nonmenstrual TSS were younger than those with menstrual TSS but had the same mortality rate. Children <16 years of age accounted for 39% of TSS cases, most caused by burns and skin and soft tissue infections. Nonmenstrual TSS is now more common than menstrual TSS in the UK, although both types are strongly associated with the tst+ clonal complex (CC) 30 methicillin-sensitive S. aureus lineage, which accounted for 49.4% of all TSS and produced more TSST-1 and superantigen bioactivity than did tst+ CC30 methicillin-resistant S. aureus strains. Better understanding of this MSSA lineage and infections in children could focus interventions to prevent TSS in the future.
Highlights
Medscape, LLC designates this Journal-based CME activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)TM
We considered the apparent rise in cases during 2008– 2009 an artifact of increased clinical awareness of severe toxigenic S. aureus disease from late 2008, prompted by national guidance on toxin-producing S. aureus (Figure 1)
CC30 Methicillin-sensitive S. aureus (MSSA) is a prevalent lineage in the United Kingdom [16], so ongoing surveillance and clinical vigilance for toxic shock syndrome (TSS) are important
Summary
LLC designates this Journal-based CME activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)TM. All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: [1] review the learning objectives and author disclosures; [2] study the education content; [3] take the post-test with a 75% minimum passing score and complete the evaluation at http://www.medscape.org/journal/eid; and [4] view/print certificate. Assess the clinical features and epidemiology of toxic shock syndrome (TSS) in England, Wales, and Northern Ireland, based on a study using UK national surveillance data. BS, has disclosed no relevant financial relationships
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