[A new exanthematous disease in newborn infants caused by exotoxins producing methicillin-resistant Staphylococcus aureus; pathology from viewpoints of local and systemic levels of exotoxin and cytokine].
[A new exanthematous disease in newborn infants caused by exotoxins producing methicillin-resistant Staphylococcus aureus; pathology from viewpoints of local and systemic levels of exotoxin and cytokine].
复制标题
[一种新的新生儿出疹性疾病，由产生外毒素的耐甲氧西林金黄色葡萄球菌引起；
DOI：
10.11150/kansenshogakuzasshi1970.74.573
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发表时间：
2000
期刊：
影响因子：
--
通讯作者：
R. Sakai
中科院分区：
文献类型：
--
作者：
T. Okada;A. Makimoto;A. Kitamura;S. Furukawa;K. Miwa;R. Sakai
由中毒性休克综合征毒素-1 （TSST-1）产生的耐甲氧西林金黄色葡萄球菌（MRSA）引起的新生儿疹性疾病是日本新兴的传染病之一。我们在国立香川儿童医院收集了36例本病患者，并对其中13例进行了毒素和细胞因子在其发病机制中的作用研究。研究结果总结如下：1。在脐带感染引起的脐炎性渗出液和呼吸道感染引起的胃液中，TSST-1水平较高。绝大多数渗出病例血TSST-1水平均低于检出限，但在9例呼吸道感染和1例继发于严重MRSA感染（臀部痰脓肿）的病例中检出TSST-1。2. 局部细胞因子水平检测的脓肿脓液来自一个严重的MRSA感染病例和胃液来自呼吸道感染引起的病例。局部TNF [α]、IL-1 [β]、IL-6和IL-8水平明显升高，但局部IL-2和IFN-[γ]水平与血药水平相似。3. 高细胞素血症（IL-1 [β]、IL-2、IL-6、IFN-[γ]）的严重程度与疹性疾病的严重程度成正比。伴随着抑制因子sTNF-R、IL-1 ra、sIL-2R和IL-10水平的升高，这种高细胞素血症在4 - 5天内很快恢复正常。4. 与脐带感染相比，呼吸道感染患者血液细胞因子水平较高，部分患者出现心肺功能障碍。基于本研究结果，我们认为本病一般为MRSA感染引起的毒血症，毒素数量少，无组织破坏性病变，这与疾病的病程密切相关，有自发恢复的倾向。
Neonatal exanthematous diseases induced by toxic shock syndrome toxin-1 (TSST-1)-producing methicillin-resistant Staphyloccocus aureus (MRSA) is one of emerging infectious diseases in Japan. We experienced 36 patients with this disease in National Kagawa Children's Hospital and in 13 patients of them, investigated the role of both the toxin and cytokines in pathogenesis of it. The results are summarized as follows: 1. The TSST-1 level was high in the umbilical inflammatory exudate of cases induced by umbilical infection and in the gastric fluid of cases induced by respiratory infection. The blood TSST-1 level was below the detection limit in most of the exathematous++ cases examined, but it was detected in one of the nine cases induced by respiratory infection and a case secondary to severe MRSA infection (phlegmonous abscess in buttock). 2. Local cytokine levels were examined in the abscess pus obtained from a case of severe MRSA infection and in the gastric fluid from cases induced by respiratory infection. The local levels of TNF [alpha], IL-1 [beta], IL-6 and IL-8 were markedly high, but the local levels of IL-2 and IFN-[gamma] were similar to their blood levels. 3. The severity of hypercytokinemia (IL-1 [beta], IL-2, IL-6, IFN-[gamma]) was proportionate to the severity of exanthematous disease. Accompanied by increased levels of inhibitory factors sTNF-R, IL-1 ra, sIL-2R and IL-10, this hypercytokinemia normalized soon within four or five days. 4. As compared to cases induced by umbilical infection, cases induced by respiratory infection often had higher blood cytokine levels and some of them had cardiorespiratory disorders. Based on the results of this study, we consider that this disease is generally induced by toxemia with a small number of toxins without tissue destructive lesions by MRSA infection and that this is closely related to the course of the disease that shows a tendency to a spontaneous recovery.