This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints and Permissions Copyright Information Books from ASM Press MicrobeWorld Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Parsonnet, J. Articles by Onderdonk, A. B. Search for Related Content PubMed PubMed Citation Articles by Parsonnet, J. Articles by Onderdonk, A. B.

 Previous Article  |  Next Article 

Journal of Clinical Microbiology, September 2005, p. 4628-4634, Vol. 43, No. 9
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.9.4628-4634.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Prevalence of Toxic Shock Syndrome Toxin 1-Producing Staphylococcus aureus and the Presence of Antibodies to This Superantigen in Menstruating Women

Jeffrey Parsonnet,¹ Melanie A. Hansmann,^2* Mary L. Delaney,³ Paul A. Modern,¹ Andrea M. DuBois,³ Wendy Wieland-Alter,¹ Kimberly W. Wissemann,² John E. Wild,⁴ Michaelle B. Jones,² Jon L. Seymour,² and Andrew B. Onderdonk³

Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire,¹ The Procter & Gamble Company, Cincinnati, Ohio,² Channing Laboratory, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts,³ Hill Top Research, Cincinnati, Ohio⁴

Received 22 March 2005/ Returned for modification 3 June 2005/ Accepted 17 June 2005

Menstrual toxic shock syndrome (mTSS) is thought to be associated with colonization with toxic shock syndrome toxin 1 (TSST-1)-producing Staphylococcus aureus in women with insufficient antibody titers. mTSS has been associated with menstruation and tampon use, and although it is rare, the effects can be life threatening. It remains of interest because of the widespread use of tampons, reported to be about 70% of women in the United States, Canada, and much of Western Europe. This comprehensive study was designed to determine S. aureus colonization and TSST-1 serum antibody titers in 3,012 menstruating women in North America between the ages of 13 and 40, particularly among age and racial groups that could not be assessed reliably in previous small studies. One out of every four subjects was found to be colonized with S. aureus in at least one of three body sites (nose, vagina, or anus), with approximately 9% colonized vaginally. Eighty-five percent of subjects had antibody titers (1:32) to TSST-1, and the vast majority (81%) of teenaged subjects (13 to 18 years) had already developed antibody titers. Among carriers of toxigenic S. aureus, a significantly lower percentage of black women than of white or Hispanic women were found to have antibody titers (1:32) to TSST-1 (89% versus 98% and 100%). These findings demonstrate that the majority of teenagers have antibody titers (1:32) to TSST-1 and are presumed to be protected from mTSS. These findings also suggest that black women may be more susceptible to mTSS than previously thought.

---

* Corresponding author. Mailing address: The Procter & Gamble Company, Winton Hill Business Center, 6110 Center Hill Avenue, Cincinnati, OH 45224. Phone: (513) 634-6040. Fax: (513) 634-7364. E-mail: hansmann.ma{at}pg.com.

---

Journal of Clinical Microbiology, September 2005, p. 4628-4634, Vol. 43, No. 9
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.9.4628-4634.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

This article has been cited by other articles:

• Parsonnet, J., Goering, R. V., Hansmann, M. A., Jones, M. B., Ohtagaki, K., Davis, C. C., Totsuka, K. (2008). Prevalence of Toxic Shock Syndrome Toxin 1 (TSST-1)-Producing Strains of Staphylococcus aureus and Antibody to TSST-1 among Healthy Japanese Women. J. Clin. Microbiol. 46: 2731-2738 [Abstract] [Full Text]  
• Bonness, S., Szekat, C., Novak, N., Bierbaum, G. (2008). Pulsed-Field Gel Electrophoresis of Staphylococcus aureus Isolates from Atopic Patients Revealing Presence of Similar Strains in Isolates from Children and Their Parents. J. Clin. Microbiol. 46: 456-461 [Abstract] [Full Text]  
• Schlievert, P. M., Case, L. C., Strandberg, K. L., Tripp, T. J., Lin, Y.-C., Peterson, M. L. (2007). Vaginal Staphylococcus aureus Superantigen Profile Shift from 1980 and 1981 to 2003, 2004, and 2005. J. Clin. Microbiol. 45: 2704-2707 [Abstract] [Full Text]  
• Brown, C. J., Wong, M., Davis, C. C., Kanti, A., Zhou, X., Forney, L. J. (2007). Preliminary characterization of the normal microbiota of the human vulva using cultivation-independent methods. J Med Microbiol 56: 271-276 [Abstract] [Full Text]