Details:

Alternative Title:
PLoS One
Publisher's site:
http://dx.doi.org/10.1371/journal.pone.0022997
Personal Author:
DeVries, Aaron S. ; Lesher, Lindsey ; Schlievert, Patrick M. ; Rogers, Tyson ; Villaume, Lourdes G. ; ... More +
DeVries, Aaron S. ; Lesher, Lindsey ; Schlievert, Patrick M. ; Rogers, Tyson ; Villaume, Lourdes G. ; Danila, Richard ; Lynfield, Ruth ; Less -
Description:
Introduction Circulating strains of Staphylococcus aureus (SA) have changed in the last 30 years including the emergence of community-associated methicillin-resistant SA (MRSA). A report suggested staphylococcal toxic shock syndrome (TSS) was increasing over 2000–2003. The last population-based assessment of TSS was 1986. Methods Population-based active surveillance for TSS meeting the CDC definition using ICD-9 codes was conducted in the Minneapolis-St. Paul area (population 2,642,056) from 2000–2006. Medical records of potential cases were reviewed for case criteria, antimicrobial susceptibility, risk factors, and outcome. Superantigen PCR testing and PFGE were performed on available isolates from probable and confirmed cases. Results Of 7,491 hospitalizations that received one of the ICD-9 study codes, 61 TSS cases (33 menstrual, 28 non-menstrual) were identified. The average annual incidence per 100,000 of all, menstrual, and non-menstrual TSS was 0.52 (95% CI, 0.32–0.77), 0.69 (0.39–1.16), and 0.32 (0.12–0.67), respectively. Women 13–24 years had the highest incidence at 1.41 (0.63–2.61). No increase in incidence was observed from 2000–2006. MRSA was isolated in 1 menstrual and 3 non-menstrual cases (7% of TSS cases); 1 isolate was USA400. The superantigen gene tst-1 was identified in 20 (80%) of isolates and was more common in menstrual compared to non-menstrual isolates (89% vs. 50%, p = 0.07). Superantigen genes sea, seb and sec were found more frequently among non-menstrual compared to menstrual isolates [100% vs 25% (p = 0.4), 60% vs 0% (p<0.01), and 25% vs 13% (p = 0.5), respectively]. Discussion TSS incidence remained stable across our surveillance period of 2000–2006 and compared to past population-based estimates in the 1980s. MRSA accounted for a small percentage of TSS cases. tst-1 continues to be the superantigen associated with the majority of menstrual cases. The CDC case definition identifies the most severe cases and has been consistently used but likely results in a substantial underestimation of the total TSS disease burden.
Subject:
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Adolescent
Adult
Aged
Aged, 80 And Over
Child
Child, Preschool
Female
Humans
Infant
Male
Middle Aged
Shock, Septic
Staphylococcal Infections
Staphylococcus Aureus
Young Adult

Source:
PLoS One. 2011 ; 6(8).;
Pubmed ID:
21860665
Pubmed Central ID:
PMC3157910
Document Type:
Journal Article ;
Funding:
5 R01 CI000209/CI/NCPDCID CDC HHS/United States ; L30 AI 071582-01/AI/NIAID NIH HHS/United States ; R01-AI06461/AI/NIAID NIH HHS/United States ; T32 AI 055433-2/AI/NIAID NIH HHS/United States ; U54-AI57153/AI/NIAID NIH HHS/United States ;
5 R01 CI000209/CI/NCPDCID CDC HHS/United States ; L30 AI 071582-01/AI/NIAID NIH HHS/United States ; R01-AI06461/AI/NIAID NIH HHS/United States ; T32 AI 055433-2/AI/NIAID NIH HHS/United States ; U54-AI57153/AI/NIAID NIH HHS/United States ; Less -
Place as Subject:
Minnesota ;
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:89559aa01af8e1578c140b198ba7d1280fa4165a7168792741d4d0e3dde92009
File Type:

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