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Journal of Clinical Microbiology, August 2008, p. 2731-2738, Vol. 46, No. 8
0095-1137/08/$08.00+0     doi:10.1128/JCM.00228-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.

Prevalence of Toxic Shock Syndrome Toxin 1 (TSST-1)-Producing Strains of Staphylococcus aureus and Antibody to TSST-1 among Healthy Japanese Women{triangledown}

Jeffrey Parsonnet,1 Richard V. Goering,2 Melanie A. Hansmann,3* Michaelle B. Jones,3 Kumiko Ohtagaki,4 Catherine C. Davis,3 and Kyoichi Totsuka5

Infectious Disease Section, Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire,1 Department of Medical Microbiology and Immunology, Creighton University School of Medicine, Omaha, Nebraska,2 Procter & Gamble, Cincinnati, Ohio,3 Procter and Gamble Far East, Kobe, Japan,4 Department of Infectious Diseases, Tokyo Women's Medical University School of Medicine, Tokyo, Japan5

Received 4 February 2008/ Returned for modification 5 May 2008/ Accepted 30 May 2008

Many cases of neonatal toxic shock syndrome (TSS)-like exanthematous disease but few cases of menstrual TSS (mTSS) have been reported in Japan. We determined the prevalence of mucosal colonization with Staphylococcus aureus and of positive antibodies to TSS toxin 1 (TSST-1) among 209 healthy Japanese women in Tokyo. S. aureus isolates from mucosal sites were characterized with respect to TSST-1 production and resistance genotype. Antibody titers were determined for test subjects and for 133 Japanese and 137 Caucasian control women living in the United States. S. aureus was isolated from at least one site in 108 of 209 women (52%) in Tokyo. Of the 159 S. aureus isolates recovered, 14 (9%) were TSST-1 positive (12 unique strains). Twelve of 209 women (6%) were colonized with a TSST-1-producing strain; two (<1%) had vaginal colonization. Only 2 of 12 unique toxigenic strains (14%) were methicillin resistant. Of the 12 TSST-1-positive strains isolated, 6 (50%) were pulsed-field gel electrophoresis type USA200, multilocus sequence type clonal complex 30. Fewer Japanese women in Tokyo (47%) than Caucasian and Japanese women in the United States (89% and 75%, respectively) had TSST-1 antibodies. The prevalences of colonization with TSST-1-producing S. aureus were comparable in Japan and the United States, despite low seropositivity to TSST-1 in Japan. Environmental factors appear to be important in promoting the development of anti-TSST-1 antibodies, as there was a significant difference in titers between Japanese women living in Tokyo and those living in the United States. Most colonizing TSST-1-producing S. aureus strains in Japan were genotypically similar to mTSS strains found in the United States.

* Corresponding author. Mailing address: The Procter & Gamble Company, Winton Hill Business Center FC1B13, 6110 Center Hill Avenue, Cincinnati, OH 45224. Phone: (513) 634-6040. Fax: (866) 350-3201. E-mail: hansmann.ma{at}pg.com

{triangledown} Published ahead of print on 11 June 2008.

Journal of Clinical Microbiology, August 2008, p. 2731-2738, Vol. 46, No. 8
0095-1137/08/$08.00+0     doi:10.1128/JCM.00228-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.





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