Group B streptococcal toxic shock-like syndrome: report of a case and purification of an associated pyrogenic toxin

Patrick M Schlievert; John E Gocke; James R Deringer

doi:10.1093/clinids/17.1.26

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Group B streptococcal toxic shock-like syndrome: report of a case and purification of an associated pyrogenic toxin

Journal article

Peer reviewed

Group B streptococcal toxic shock-like syndrome: report of a case and purification of an associated pyrogenic toxin

Patrick M Schlievert, John E Gocke and James R Deringer

Clinical infectious diseases, Vol.17(1), pp.26-31

07/1993

DOI: 10.1093/clinids/17.1.26

PMID: 8353243

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Abstract

A patient with streptococcal toxic shock-like syndrome (TSLS) caused by Streptococcus agalactiae (group B Streptococcus) is described. The patient had all of the defining criteria for toxic shock syndrome (TSS), including fever, hypotension, erythematous rash, desquamation, and involvement of multiple organs. Neither Staphylococcus aureus nor group A streptococci were recovered, but vaginal and urine cultures yielded group B streptococci. The group B streptococcal isolate gave negative results in antibody tests for the production of TSS toxin 1, staphylococcal enterotoxins, and streptococcal scarlet fever toxins. However, the strain produced a novel pyrogenic toxin. This toxin, purified from culture fluids by ethanol precipitation, isoelectric focusing, and reverse-phase high-pressure liquid chromatography, had a molecular weight of 12,000 and an isoelectric point of approximately 7.0. The purified toxin was pyrogenic in rabbits, enhanced the susceptibility of the animals to lethal endotoxin shock, and caused the proliferation of rabbit splenocytes; these properties define pyrogenic toxins. When given to three rabbits via a subcutaneous miniosmotic pump, the toxin caused TSS-like symptoms ending in death. Three additional group B streptococcal strains from patients with TSLS were tested and were found to produce a toxin with similar properties.

Exotoxins - isolation & purification

Rabbits

Shock, Septic - etiology

Streptococcus agalactiae - pathogenicity

Humans

Pyrogens - isolation & purification

Bacterial Proteins

Shock, Septic - microbiology

Membrane Proteins

Streptococcus agalactiae - isolation & purification

Animals

Adult

Biological Assay

Female

Streptococcus agalactiae - chemistry

Details

Title: Subtitle: Group B streptococcal toxic shock-like syndrome: report of a case and purification of an associated pyrogenic toxin
Creators: Patrick M Schlievert - Department of Microbiology, University of Minnesota Medical School, Minneapolis 55455
John E Gocke
James R Deringer
Resource Type: Journal article
Publication Details: Clinical infectious diseases, Vol.17(1), pp.26-31
Publisher: United States
DOI: 10.1093/clinids/17.1.26
PMID: 8353243
ISSN: 1058-4838
eISSN: 1537-6591
Grant note: HL 36611 / NHLBI NIH HHS
Language: English
Date published: 07/1993
Academic Unit: Microbiology and Immunology; Internal Medicine
Record Identifier: 9984002391502771

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