The production of toxic shock syndrome toxin 1 by S. aureus in the tampon sac method is highly sensitive to the type of medium and the addition of blood components.
Toxin yield in tampon sac models is medium- and serum-sensitive; hypothesis-generating for S. aureus virulence factors in menstrual TSS.
The use of three different agar concentrations in the tampon sac method resulted in slightly higher fluid uptake by the tampons when a 0.5% agar concentration was used. However, there was essentially no difference in the total amount of toxin produced. The largest amount of toxic shock syndrome toxin 1 was produced with brain heart infusion agar, followed closely by 3% NZ-amine NAK-1% yeast extract medium. The addition of plasma and serum to the inoculum resulted in increases (62 and 73%, respectively) in toxin production. The addition of whole blood to the inoculum had a variable effect on toxin production, with an increase in the amount of toxin produced with some tampons and not with others. Over fivefold differences in the amount of toxin produced were obtained when duplicate experiments were done on successive days, whereas the differences were less than twofold for experiments done on the same day. This was related to the effect of small changes in the parameters on toxic shock syndrome toxin 1 production.
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Reiser et al. (1988) studied this question.
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