Clinical and molecular epidemiology of staphylococcal toxic shock syndrome in the United Kingdom

Hema Sharma, Debra Smith, Claire E. Turner, Laurence Game, Bruno Pichon, Russell Hope, Robert Hill, Angela Kearns, Shiranee Sriskandan

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)

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 cases 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.

Original languageEnglish
Pages (from-to)258-266
Number of pages9
JournalEmerging Infectious Diseases
Volume24
Issue number2
DOIs
Publication statusPublished - Feb 2018

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