ArticlePloS one2011
Staphylococcal toxic shock syndrome 2000-2006: epidemiology, clinical features, and molecular characteristics.
Article in PloS one, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 67 papers, 1 of them a synthesis that pooled it.
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Who cites it
67 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Acute heart failure associated with toxic shock syndrome due to methicillin-susceptible Staphylococcus aureus during the postpartum period: case report and systematic literature review.BMC cardiovascular disorders · 2022Pooled it
- Fatal Panton-Valentine leukocidin-positive MSSA toxic shock syndrome: a call for rapid virulence detection and optimized antimicrobial therapy.Frontiers in cellular and infection microbiology · 2026Article
- Tattoo-associated toxic shock syndrome: a case report.International journal of emergency medicine · 2025Article
- Postoperative Staphylococcal Toxic Shock Syndrome in a Patient Following Right Knee Fracture Repair: A Case Report.Cureus · 2025Article
- Directional and Strain-Specific Interaction BetweenMicroorganisms · 2024Article
- Vaccines and monoclonal antibodies to prevent healthcare-associated bacterial infections.Clinical microbiology reviews · 2024Review
- Toxic Shock Syndrome: A Literature Review.Antibiotics (Basel, Switzerland) · 2024Review
- A randomized, double-blind study on the safety and immunogenicity of rTSST-1 variant vaccine: phase 2 results.EClinicalMedicine · 2024Article
- An Overview of Clinical Manifestations of Dermatological Disorders in Intensive Care Units: What Should Intensivists Be Aware of?Diagnostics (Basel, Switzerland) · 2023Review
- Toxin exposure and HLA alleles determine serum antibody binding to toxic shock syndrome toxin 1 (TSST-1) ofFrontiers in immunology · 2023Article
- The safety assessment of tampons: illustration of a comprehensive approach for four different products.Frontiers in reproductive health · 2023Article
- Staphylococcal Toxic Shock Syndrome after Autologous Breast Reconstruction: A Case Report and Literature Review.Plastic and reconstructive surgery. Global open · 2022Article
- Superantigens, a Paradox of the Immune Response.Toxins · 2022Review
- The Association Between Onset of Staphylococcal Non-menstrual Toxic Shock Syndrome With Inducibility of Toxic Shock Syndrome Toxin-1 Production.Frontiers in microbiology · 2022Article
- Genital Tract GAS Infection ISIDOG Guidelines.Journal of clinical medicine · 2021Review
- The Prevalence of Virulence Determinants and Antibiotic Resistance Patterns in Methicillin-ResistantPathogens (Basel, Switzerland) · 2021Article
- An overlooked cause of septic shock: Staphylococcal Toxic Shock Syndrome secondary to an axillary abscess.IDCases · 2021Article
- Device-Associated Menstrual Toxic Shock Syndrome.Clinical microbiology reviews · 2020Review
- Toxic Shock Syndrome after Surgery: Case Presentation and Systematic Review of the Literature.Plastic and reconstructive surgery. Global open · 2020Article
- Menstrual TSS remains a dangerous threat.EClinicalMedicine · 2020Article
7 more citing papers are in PubMed but not listed here.
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Authors and funding
7 authors.
Funding
Abstract
introductionCirculating strains of Staphylococcus aureus (SA) have changed in the last 30 years including the emergence of community-associated methicillin-resistant SA (MRSA). A report suggested staphylococcal toxic shock syndrome (TSS) was increasing over 2000-2003. The last population-based assessment of TSS was 1986.
methodsPopulation-based active surveillance for TSS meeting the CDC definition using ICD-9 codes was conducted in the Minneapolis-St. Paul area (population 2,642,056) from 2000-2006. Medical records of potential cases were reviewed for case criteria, antimicrobial susceptibility, risk factors, and outcome. Superantigen PCR testing and PFGE were performed on available isolates from probable and confirmed cases.
resultsOf 7,491 hospitalizations that received one of the ICD-9 study codes, 61 TSS cases (33 menstrual, 28 non-menstrual) were identified. The average annual incidence per 100,000 of all, menstrual, and non-menstrual TSS was 0.52 (95% CI, 0.32-0.77), 0.69 (0.39-1.16), and 0.32 (0.12-0.67), respectively. Women 13-24 years had the highest incidence at 1.41 (0.63-2.61). No increase in incidence was observed from 2000-2006. MRSA was isolated in 1 menstrual and 3 non-menstrual cases (7% of TSS cases); 1 isolate was USA400. The superantigen gene tst-1 was identified in 20 (80%) of isolates and was more common in menstrual compared to non-menstrual isolates (89% vs. 50%, p = 0.07). Superantigen genes sea, seb and sec were found more frequently among non-menstrual compared to menstrual isolates [100% vs 25% (p = 0.4), 60% vs 0% (p<0.01), and 25% vs 13% (p = 0.5), respectively]. DISCUSSION: TSS incidence remained stable across our surveillance period of 2000-2006 and compared to past population-based estimates in the 1980s. MRSA accounted for a small percentage of TSS cases. tst-1 continues to be the superantigen associated with the majority of menstrual cases. The CDC case definition identifies the most severe cases and has been consistently used but likely results in a substantial underestimation of the total TSS disease burden.
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