Induction of Interleukin-l by Strains of Staphylococcus aureus from Patients with Nonmenstrual Toxic Shock Syndrome

We studied the induction of human interleukin-1 (IL-1) production in strains of Staphylococcus aureus isolated from patients with nonmenstrual toxic shock syndrome (TSS). Of the 20 TSS-associated strains studied, 11 produced and nine did not produce TSS toxin-1 (TSST-1). Human monocytes were incubated with dilute staphylococcal supernatants, and IL-1 production was measured in a lymphocyte-activating factor assay. All 20 TSS-associated strains were potent inducers of IL-1, in comparison with none of 10 vaginal isolates of S. aureus from healthy women. TSST-1-positive strains were more potent than TSST-1-negative strains. Nine TSST-1-negative TSS-associated strains were compared with 14 strains of S. aureus from other clinical settings and were found to be significantly more potent inducers of IL-1 (P less than .01). Eight of these nine TSS-associated strains produced at least one staphylococcal enterotoxin. Stimulation of monocytes by products of S. aureus may play a role in the pathogenesis of TSS.