Staphylococcal Toxic Shock Syndrome Complicating Influenza A Infection in a Young Child

Peters, Timothy R.; Hammon, Dudley E; Jarrah, Rima J.; Palavecino, Elizabeth; Blakeney, Elizabeth S; Poehling, Katherine A.

doi:10.5402/2011/645718

Cited by 4 publications

(6 citation statements)

References 12 publications

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“…MRSA is a major nosocomial pathogen worldwide which has emerged over the past 30 years as a leading cause of both nosocomial and community-acquired infections. [3,4] Methicillin resistance is caused by the presence of mecA gene, which encodes an additional 78 kDa low-affinity penicillin binding protein (PBP)-2a or PBP2' which has a low affinity for β-lactam antibiotics. [5] There has been a steady increase in the prevalence of MRSA all over the world.…”

Section: Introductionmentioning

confidence: 99%

Detection of Methicillin Resistance in Staphylococcus Aureus by Polymerase Chain Reaction and Conventional Methods: A Comparative Study

Pillai

Ragunathan²,

Sarkar

2012

J Lab Physicians

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Background:Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen worldwide, which has emerged over the past 30 years as a leading cause of both nosocomial and community-acquired infections. Accurate and rapid identification of MRSA in clinical specimens is essential for timely decision on effective antimicrobial chemotherapy.Aim:The present study was conducted to compare two conventional phenotypic methods, oxacillin disk diffusion (ODD) method and mannitol salt agar (MSA) with oxacillin, with polymerase chain reaction (PCR) for mecA gene (as standard).Materials and Methods:A total of 165 consecutive clinical isolates of S. aureus received at the Department of Microbiology in our tertiary care teaching hospital were included in the study. All the isolates were subjected to ODD (1 μg) method, culture in MSA with oxacillin, and PCR for mecA gene.Results:The sensitivity and specificity of ODD test were found to be 93.5% (86.4-97.3%) and 83.5% (79.2-85.8%), respectively, and that of MSA with oxacillin were found to be 87.1% (79.5-92.3%) and 89.3% (84.8-92.5%), respectively. The time taken for diagnosing MRSA by conventional methods is 48-72 h, which is more as compared to PCR which takes 18-24 h.Conclusion:This study recommends advocating PCR for mecA gene on a regular basis for detecting methicillin resistance in S. aureus isolates isolated from sterile body fluids or from special units such as intensive care units.

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Section: Introductionmentioning

confidence: 99%

Detection of Methicillin Resistance in Staphylococcus Aureus by Polymerase Chain Reaction and Conventional Methods: A Comparative Study

Pillai

Ragunathan²,

Sarkar

2012

J Lab Physicians

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“…The disease is uncommon in children but sometimes is occurred following staphylococcal infections. This disease was rarely reported following influenza infections (1,7,8) and after searching the related literature, our case is the first reported pediatric case. Although in this case the coinfection of influenza and staphylococci infection was not ruled out.…”

Section: Discussionmentioning

confidence: 64%

“…Arch Pediatr Infect Dis. 2014;2(3):e14672 following influenza infections (7,8) and, like most of the reported cases, had not received influenza vaccine. As a result, influenza vaccination, particularly in young children can strongly reduce most of the secondary bacterial infections and is highly recommended (1, 4, 5).…”

mentioning

confidence: 78%

“…The ESR (erythrocyte sedimentation rate) and CRP (C-reactive protein) levels were not very high and we excluded Kawasaki disease due to the absence of typical and atypical KD criteria and presence of hypotension and rapidly progressive illness, so we did not performed echocardiography. Most cases reported the toxic shock syndrome as a secondary disease of influenza, were followed by upper and lower respiratory tract Staphylococcus aureus infections (tracheaitis, sinusitis, pneumonia) (7,8) which is usually associated with persistent fever and worsening of illness. TSS also can occur without any identifiable focus of infection (4).…”

Section: Discussionmentioning

confidence: 99%

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Toxic Shock Syndrome Following Influenza-like Illness: The First Case Report in a Young Child

Aghdam

Eftekhari

2013

Arch Pediatr Infect Dis

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Toxic shock syndrome in children following infection with influenza is a very rare syndrome. If it is not diagnosed quickly, it may cause significant morbidity and mortality. For diagnosis of toxic shock syndrome, clinical and laboratory criteria are used. Our patient is a 3.5year old boy who admitted to the hospital with high fever, weakness, toxicity, hypotension and skin rash due to influenza-like Illness (fever, pharyngitis, rhinitis and non-productive cough) associated with gastrointestinal symptoms, elevated liver enzymes levels, low platelet count and mucosal hyperemia. After the treatment, he recovered and was discharged from the hospital in good condition, but had mild scaling on the soles of the feet and between toes. To our knowledge, this is the first reported case in a young child. There is not any specific diagnostic test for toxic shock syndrome diagnosis, and the diagnosis is based on clinical and laboratory findings. Therefore, the early detection and treatment of the condition is very important because delay in treatment leads to increased mortality and morbidity.

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“…Since these tests also provide information about antibiotic resistance of the microorganism present, they could guide appropriate antibiotic treatment for patients. However in situations where a patient’s blood culture is negative for microorganisms, for example, in a case of deep tissue infection by Staphylococcus aureus or Streptococcus pyogenes , the patient could still develop shock-like or inflammatory symptoms that might arise due to the secretion of superantigenic toxins by the bacteria [ 47 – 49 ]. In such situations, or in cases when bacterial burden in blood is minimal, methods that detect the toxin directly could be useful.…”

Section: Discussionmentioning

confidence: 99%

A Multiplex Assay for Detection of Staphylococcal and Streptococcal Exotoxins

et al. 2015

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Staphylococcal and streptococcal exotoxins, also known as superantigens, mediate a range of diseases including toxic shock syndrome, and they exacerbate skin, pulmonary and systemic infections caused by these organisms. When present in food sources they can cause enteric effects commonly known as food poisoning. A rapid, sensitive assay for the toxins would enable testing of clinical samples and improve surveillance of food sources. Here we developed a bead-based, two-color flow cytometry assay using single protein domains of the beta chain of T cell receptors engineered for high-affinity for staphylococcal (SEA, SEB and TSST-1) and streptococcal (SpeA and SpeC) toxins. Site-directed biotinylated forms of these high-affinity agents were used together with commercial, polyclonal, anti-toxin reagents to enable specific and sensitive detection with SD50 values of 400 pg/ml (SEA), 3 pg/ml (SEB), 25 pg/ml (TSST-1), 6 ng/ml (SpeA), and 100 pg/ml (SpeC). These sensitivities were in the range of 4- to 80-fold higher than achieved with standard ELISAs using the same reagents. A multiplex format of the assay showed reduced sensitivity due to higher noise associated with the use of multiple polyclonal agents, but the sensitivities were still well within the range necessary for detection in food sources or for rapid detection of toxins in culture supernatants. For example, the assay specifically detected toxins in supernatants derived from cultures of Staphylococcus aureus. Thus, these reagents can be used for simultaneous detection of the toxins in food sources or culture supernatants of potential pathogenic strains of Staphylococcus aureus and Streptococcus pyogenes.

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Staphylococcal Toxic Shock Syndrome Complicating Influenza A Infection in a Young Child

Cited by 4 publications

References 12 publications

Detection of Methicillin Resistance in Staphylococcus Aureus by Polymerase Chain Reaction and Conventional Methods: A Comparative Study

Detection of Methicillin Resistance in Staphylococcus Aureus by Polymerase Chain Reaction and Conventional Methods: A Comparative Study

Toxic Shock Syndrome Following Influenza-like Illness: The First Case Report in a Young Child

A Multiplex Assay for Detection of Staphylococcal and Streptococcal Exotoxins

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