BACKGROUND: Staphylococcus aureus has numerous virulence factors, including exotoxins that may increase the severity of infection. This study was aimed at assessing whether preexisting antibodies to S. aureus toxins are associated with a lower risk of sepsis in adults with S. aureus infection complicated by bacteremia. METHODS: We prospectively identified adults with S. aureus infection from 4 hospitals in Baltimore, MD, in 2009–2011. We obtained serum samples from prior to or at presentation of S. aureus bacteremia to measure total immunoglobulin G (IgG) and IgG antibody levels to 11 S. aureus exotoxins. Bacterial isolates were tested for the genes encoding S. aureus exotoxins using polymerase chain reaction (PCR). RESULTS: One hundred eligible subjects were included and 27 of them developed sepsis. When adjusted for total IgG levels and stratified for the presence of toxin in the infecting isolate as appropriate, the risk of sepsis was significantly lower in those patients with higher levels of IgG against α-hemolysin (Hla), δ-hemolysin (Hld), Panton Valentine leukocidin (PVL), staphylococcal enterotoxin C-1 (SEC-1), and phenol-soluble modulin α3 (PSM-α3). CONCLUSIONS: Our results suggest that higher antibody levels against Hla, Hld, PVL, SEC-1, and PSM-α3 may protect against sepsis in patients with invasive S. aureus infections.
BACKGROUND:Staphylococcus aureus has numerous virulence factors, including exotoxins that may increase the severity of infection. This study was aimed at assessing whether preexisting antibodies to S. aureus toxins are associated with a lower risk of sepsis in adults with S. aureus infection complicated by bacteremia. METHODS: We prospectively identified adults with S. aureus infection from 4 hospitals in Baltimore, MD, in 2009–2011. We obtained serum samples from prior to or at presentation of S. aureusbacteremia to measure total immunoglobulin G (IgG) and IgG antibody levels to 11 S. aureus exotoxins. Bacterial isolates were tested for the genes encoding S. aureus exotoxins using polymerase chain reaction (PCR). RESULTS: One hundred eligible subjects were included and 27 of them developed sepsis. When adjusted for total IgG levels and stratified for the presence of toxin in the infecting isolate as appropriate, the risk of sepsis was significantly lower in those patients with higher levels of IgG against α-hemolysin (Hla), δ-hemolysin (Hld), Panton Valentine leukocidin (PVL), staphylococcal enterotoxin C-1 (SEC-1), and phenol-soluble modulin α3 (PSM-α3). CONCLUSIONS: Our results suggest that higher antibody levels against Hla, Hld, PVL, SEC-1, and PSM-α3 may protect against sepsis in patients with invasive S. aureus infections.
Authors: Batu K Sharma-Kuinkel; Yuling Wu; David E Tabor; Hoyin Mok; Bret R Sellman; Amy Jenkins; Li Yu; Hasan S Jafri; Thomas H Rude; Felicia Ruffin; Wiley A Schell; Lawrence P Park; Qin Yan; Joshua T Thaden; Julia A Messina; Vance G Fowler; Mark T Esser Journal: J Clin Microbiol Date: 2014-11-12 Impact factor: 5.948
Authors: Michael S Calderwood; Christopher A Desjardins; George Sakoulas; Robert Nicol; Andrea Dubois; Mary L Delaney; Ken Kleinman; Lisa A Cosimi; Michael Feldgarden; Andrew B Onderdonk; Bruce W Birren; Richard Platt; Susan S Huang Journal: J Infect Dis Date: 2013-09-16 Impact factor: 5.226
Authors: Avanish K Varshney; Xiaobo Wang; Jennifer MacIntyre; Richard S Zollner; Kerry Kelleher; Oleg V Kovalenko; Ximo Pechuan; Fergus R Byrne; Bettina C Fries Journal: J Infect Dis Date: 2014-05-05 Impact factor: 5.226
Authors: Stephanie A Fritz; Kristin M Tiemann; Patrick G Hogan; Emma K Epplin; Marcela Rodriguez; Duha N Al-Zubeidi; Juliane Bubeck Wardenburg; David A Hunstad Journal: Clin Infect Dis Date: 2013-02-27 Impact factor: 9.079