Staphylococcus aureus - Intoxications

2. INTOXICATIONS

1. Food poisoning

2. Toxic shock syndrome (TSS)

3. Staphylococcal scalded skin syndrome (SSSS)

 

1. Food poisoning: (Enterotoxin)

•Enterotoxin is responsible for manifestations of staphylococcal food poisoning

•Nine types of enterotoxin are currently known, named A, B, C1-3, D, E, H & I.

•It usually occurs when preformed toxin is ingested with contaminated food- milk and milk products, meat, fish and ice cream

•The toxin acts directly on the autonomic nervous system to cause the illness, rather than gut mucosa.

• Type A toxin commonly implicated

• Toxin very potent - Microgram amounts cause illness

•Source of infection- food handler who is a carrier.

•Incubation period- 2 to 6 hours.

•Clinical symptoms- nausea, vomiting and diarrhoea etc.

• Post-antibiotic diarrhea can be caused by enterotoxin forming Staphylococci

•The illness is usually self limited, with recovery in a day or so.

 

2) Staphylococcal Toxic shock syndrome (STSS):

•Infection by TSST (Toxic shock syndrome toxin/ (formerly known as  enterotoxin type F)) produced by S.aureus.

•It is fatal multisystem disease presenting with fever, hypotension, myalgia, vomiting, diarrhoea, mucosal hyperemia and erythematous rash which desquamates subsequently.

• Wide outbreaks in menstruating women using vaginal tampons- in 1980’s

• Tampon-related TSS now rare, but occurs in other infections of the skin., mucosa, and some surgical wounds

3) Staphylococcal scalded skin syndrome (SSSS):

•Exfoliative toxin (ET) produced by S. aureus is responsible for Staphylococcal scalded skin syndrome (SSSS)

•It is a skin disease in which outer layer of epidermis gets separated from the underlying tissues

• Severe form in newborns- Ritter’s disease; in older patients-toxic epidermal necrolysis

• Milder forms in newborns-- pemphigus neonatarum and in older patients - bullous impetigo

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