@article{oai:niigata-u.repo.nii.ac.jp:00006260,
 author = {TAKIZAWA, Yoko and SHIMIZU, Takao and IWAYA, Akira and HATAKEYAMA, Katsuyoshi and TANEIKE, Ikue and NAKAGAWA, Saori and NYUZUKI, Satoru and GONDAIRA, Fumio and TSUKADA, Hiroki and GEJYO, Fumitake and YAMAMOTO, Tatsuo},
 issue = {4},
 journal = {Acta medica et biologica, Acta medica et biologica},
 month = {Dec},
 note = {Methicillin-resistant Staphylococcus aureus (MRSA), an important cause of nosocomial infections, produces a number of superantigenic toxins such as toxic shock syndrome toxin (TSST)-1 and staphylococcal enterotoxin (SE) C in many cases. However, toxic shock syndrome (TSS) only rarely occurs in MRSA infections. In this study, we isolated MRSA strains from the stool and sputum of a patient with TSS and characterized the molecular nature of the TSS-associated MRSA strains. The two MRSA strains were indistinguishable from each other, as demonstrated by pulsed-field gel electrophoresis. The coagulase type was type 2. The two MRSA strains manifested a multiple superantigenic toxin (MST) pattern of TSST-1, SEA, SEC, SEG, SEH, SEI, and SET in the PCR assay, unlike the previously characterized MRSA strains that lacked (e. g.) SEA. When human peripheral blood mononuclear cells were stimulated with superantigenic toxins, a combination of TSST-1, SEA, and SEC induced much higher levels of cytokine production than did the individual toxin or combination of (e. g.) TSST-1 and SEC. The data suggest that the MST pattern of MRSA could be a risk factor in the development of TSS.},
 pages = {141--147},
 title = {A Multiple Superantigenic Toxin Pattern of Methicillin-resistant Staphylococcus aureus (MRSA) as a Risk Factor in the Development of Toxic Shock Syndrome (TSS)},
 volume = {51},
 year = {2003}
}