Toxic shock syndrome toxin-1 (TSST-1) antibody levels in Japanese children
Toxic shock syndrome toxin-1 (TSST-1) antibody levels in Japanese children
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DOI：
10.1016/j.burns.2009.10.004
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发表时间：
2010-08-01
期刊：
影响因子：
2.7
通讯作者：
Kawakami, Shigehiko
中科院分区：
文献类型：
--
作者：
Quan, Liangliang;Morita, Reiji;Kawakami, Shigehiko
烧伤儿童患中毒性休克综合征(TSS)的风险比成人更大。这一风险被认为与抗体效价不足的儿童中产生毒性休克综合征毒素-1(TSST-1)的金黄色葡萄球菌的定植有关。TSS的诊断很困难，因为在早期阶段，其体征和症状类似于其他常见的儿童疾病，如猩红热。如果病情得不到及时治疗，死亡率很高。本研究旨在检测日本儿童TSST-1血清抗体效价，以预防TSS，促进其早期诊断。2006年5月至2007年5月，我们对金泽医科大学医院整形外科收治的119例患者进行了研究。采用酶联免疫吸附试验(EL ISA)检测患者血清中TSST-1抗体水平，6月龄以下儿童TSST-1抗体阳性率为78.6%，6~12个月年龄组TSST-1抗体阳性率最低(21.3%)。41岁以上组抗体阳性率最高(100.0%)，出生后6个月内抗体滴度较高，6个月~2岁组滴度较低。在三岁以后，效价又开始增加。TSS在2岁左右儿童中的高发病率与TSST-1抗体效价的变化有关。6个月以下的婴儿免受TSS的影响，因为他们从母亲那里获得了高水平的TSST-1抗体。当儿童的免疫系统不成熟，并且他们没有保护性的循环抗TSS抗体时，他们就有患葡萄球菌中毒性休克综合征的风险。(C)2009年爱思唯尔有限公司和ISBI。版权所有。
Children with burns have a greater risk of developing toxic shock syndrome (TSS) than adults. This risk is thought to be associated with colonisation by toxic shock syndrome toxin-1 (TSST-1)-producing Staphylococcus aureus in children with insufficient antibody titers. The diagnosis of TSS is difficult because, in the early stages, its signs and symptoms resemble those of other common childhood illnesses such as scarlet fever. If the condition is not treated promptly, the mortality rate is high. This study was designed to determine the titers of TSST-1 serum antibody in Japanese children, in order to prevent TSS and facilitate its early diagnosis.Between May 2006 and May 2007, we studied 119 patients who were treated in the Department of Plastic and Reconstructive Surgery of Kanazawa Medical University Hospital. An enzyme-linked immunosorbent assay (ELISA) was used to test the level of the IgG antibody to TSST-1 in the patients' serum samples.The percentage of cases testing for TSST-1 antibody in the patients under 6 months old was 78.6%, and it was lowest (21.3%) in the age group from 6 to 12 months old. The group of patients older than 41 years showed the highest rate of positivity (100.0%) for TSST-1 antibody.Higher titers of TSST-1 antibody were found within the first 6 months after birth, and lower titers were found between 6 months and 2 years old. The titers began to increase again after age three. The high morbidity of TSS in children around 2 years of age was proven to be related to changes in the titers of TSST-1 antibody. Infants under 6 months old are protected from TSS because of the high level of TSST-1 antibody they receive from their mother. Children are at risk of developing staphylococcal toxic shock syndrome when their immune system is immature and they have no protective circulating anti-TSS antibodies. (C) 2009 Elsevier Ltd and ISBI. All rights reserved.