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Volume 9, Number 10—October 2003
Research

Superantigens and Streptococcal Toxic Shock Syndrome

Thomas Proft*, Shiranee Sriskandan†, Lily Yang*, and John D. Fraser*Comments to Author 
Author affiliations: *University of Auckland, Auckland, New Zealand; †Imperial College, London, United Kingdom

Main Article

Table

Summary of the results from sag genotyping and SAg in vitro expressiona,b

Serum
 Isolate
 Focus
 spe-a
 SPE-A
 sag gene/SAg protein production
 SMEZc
spe-c
 SPE-C
 spe-g
 SPE-G
 spe-h
 SPE-H
 spe-i
 SPE-I
 spe-j
 SPE-J
 smez
 SMEZ
 ssa
 SSA
Focal infection/bacteremia with STSS
94/31
 H292
 Fasciitis
 -
 -
 -
 -
 +
 -
 +
 -
 +
 ++
 +
 -
 +
 -
 -
 -
 +
95/02
 H293
 Fasciitis
 -
 -
 -
 -
 +
 -
 +
 -
 -
 -
 +
 -
 +
 -
 -
 -
 ++
96/2
 H297
 Peritonitis
 +
 -
 -
 -
 +
 ++
 -
 -
 -
 -
 +
 +
 +
 -
 -
 -
 +
98/5
 H325
 Fasciitis
 +
 +++
 -
 -
 +
 -
 -
 -
 -
 -
 +
 -
 +
 -
 +
 -
 +
98/8
 H327
 Cellulitis
 -
 -
 -
 -
 +
 +
 -
 -
 -
 -
 +
 -
 +
 _
 +
 +
 -
98/11
 H330
 Endometritis
 +
 +++
 -
 -
 +
 -
 -
 -
 -
 -
 +
 +
 +
 -
 +
 -
 +
99/1
 H360
 Occult bact.
 -
 -
 +
 +
 +
 +
 -
 -
 -
 -
 +
 -
 +
 -
 -
 -
 ++
99/18
 H366
 Pneumonia
 +
 +++
 -
 -
 +
 -
 -
 -
 -
 -
 +
 ++
 +
 -
 -
 -
 +
20/07
 H378
 Pneumonia
 -
 -
 -
 -
 +
 -
 +
 -
 -
 -
 +
 -
 +
 -
 +
 -
 +
Focal infection/bacteremia, no STSS
95/8
 H295
 Cellulitis
 -
 -
 -
 -
 +
 -
 -
 -
 -
 -
 +
 +++
 +
 -
 -
 -
 ++
98/1
 H319
 Cellulitis
 -
 -
 -
 -
 +
 ++
 -
 -
 -
 -
 +
 ++
 +
 -
 -
 -
 ++
20/01
 H369
 Pelvic clot
 -
 -
 -
 -
 +
 -
 -
 -
 -
 -
 +
 +
 +
 -
 -
 -
 +++
20/04
 H370
 Thromobosis
 -
 -
 -
 -
 +
 +
 -
 -
 -
 -
 +
 -
 +
 -
 -
 -
 -
Focal infection, no bacteremia, no STSS
97/15
 H307
 Bursitis
 -
 -
 +
 +++
 +
 -
 -
 -
 -
 -
 +
 +
 +
 -
 -
 -
 +
97/18
 H308
 Cellulitis
 +
 -
 -
 -
 +
 -
 +
 -
 -
 -
 +
 -
 +
 -
 +
 -
 -
97/21
 H311
 Cellulitis
 -
 -
 -
 -
 +
 -
 -
 -
 -
 -
 +
 -
 +
 -
 -
 -
 +
97/23
 H314
 Cellulitis
 +
 -
 -
 -
 +
 +
 +
 -
 +
 -
 +
 +
 +
 -
 -
 -
 ++
97/24
 H315
 Cellulitis
 +
 -
 -
 -
 +
 -
 -
 -
 -
 -
 +
 +
 +
 -
 -
 -
 -
97/26 H316 Amnionitis - - + +++ + + - - - - + ++ + - + - -

aSAg, superantigen; SPE, streptococcal pyrogenic exotoxin; SME, streptococcal mitogenic exotoxin; STSS, streptococcal toxic shock syndrome.
bS. pyogenes isolates from patients with and without STSS were genotyped by polymerase chain reaction with sag specific primers. Concentrated supernatant from the in vitro cultured isolates were analyzed for secreted SAgs by using Western blot analysis with recombinant SAg standards. SMEZ expression was also analyzed by using the more sensitive Jurkat cell assay, which has a threshold of approximately 10 pg/mL. SAg expression by Western blot: -, no detectable protein; +, <2 ng/mL; ++, 2–10 ng/mL; +++, >10 ng/mL. SMEZ expression by Jurkat assay: -, no detectable SMEZ; +, >10 pg/ml (10,000–20,000 cpm); ++, 20,000–30,000 cpm; +++, >30,000 cpm.
cJurkat assay.

Main Article

Page created: January 10, 2011
Page updated: January 10, 2011
Page reviewed: January 10, 2011
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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