Toxin and Enzyme Characterization of Staphylococcus aureus Isolates from Patients With and Without Toxic Shock Syndrome

Vaginal isolates of Staphylococcus aureus from 19 patients with menstrual toxic shock syndrome elaborated high concentrations of pyrogenic exotoxin C, but produced low amounts of hemolysin, lipase, and nuclease. In contrast, S. aureus vaginal isolates from women without a history of toxic shock syndrome, during menstruation (14 isolates) and at times other than menstruation (22 isolates), less frequently produced pyrogenic exotoxin C and could be differentiated from isolates associated with toxic shock syndrome by production of hemolysin, lipase, and nuclease. Also, isolates from the anterior nares of 11 healthy children, and from wounds, furuncles, or abscesses from 20 persons without toxic shock syndrome produced pyrogenic exotoxin C significantly less often than the isolates from patients with toxic shock syndrome, and could be distinguished by the production of hemolysin, lipase, and nuclease.