In vitro amplification of toxic shock syndrome toxin-1 by intravaginal devices.

Super-absorbent tampons and an exotoxin of Staphylococcus aureus have been associated with the recent emergence of toxic shock syndrome (TSS). In the majority of cases, when a TSS strain of S. aureus was cultivated in the presence of various tampons and a contraceptive sponge, increased amounts of toxic shock syndrome toxin-1 (TSST-1) were observed to be produced into the blood medium by the bacterium. The amplification of toxin by these products adds support to the epidemiologic data in establishing the causal link between tampons and TSS.