Abstract
Objective. We studied the distribution of the staphylococcal superantigen genes among Kawasaki Disease (KD) patients from Jan. 1997 to Dec. 2000. Methods. Rectal and throat swabs were obtained from 175 KD patients within 6 days after the onset of fever and throat swabs were obtained from 75 age-matched control children. More than 60% of the patients had received antibiotics before the cultures were obtained. The presence of S. aureus was determined by isolating the organism or by PCR of the coagulase and/or the protein A genes. The five prototypic enterotoxins (sea, b, c, d, e) as well as the three recently characterized enterotoxins (seg, h, I) and the tsst-1 genes were amplified by PCR using the toxin-specific oligomer pairs. Results. S. aureus colonies were isolated from 32.0%, 20.7% of the throat/rectal swabs from KD, which was significantly higher than in controls (16.0%, p=0.009). By using PCR, the coagulase/protein A genes wer e amplified from 49.1%, 42.6% of the throat, rectal swabs from KD and 46.7% of the throat swabs from controls, respectively. The 7 enterotoxins (sea, b, c, d g, h, I) and the tsst-1 genes were detected from the throat and the rectal swabs wi t h the comparable frequencies. However, the seb (13% vs. 4%, p=0.04) and the sec (14% vs. 4%, p=0.02) genes were detected more frequently from the throat swabs among KD patients than controls. Conclusion. These results indicate that S. aureus, which produce various combinations of superantigens, had colonized on the throat and/or rectal mucosa of KD patients more intensively than controls. This may predispose the young children who lack the protective anti-superantigen antibodies to develop symptoms of KD.
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Abe, J., Terai, M., Nogami, H. et al. Colonization of the Superantigen-producing Staphylococcus aureus among Patients with Kawasaki Disease. Pediatr Res 53, 168 (2003). https://doi.org/10.1203/00006450-200301000-00088
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DOI: https://doi.org/10.1203/00006450-200301000-00088