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Staphylococcal Scalded Skin Syndrome: Potentiation by Immunosuppression in Mice; Toxin-Mediated Exfoliation in a Healthy Adult

机译:葡萄球菌烫伤的皮肤综合征:免疫抑制小鼠增强。健康成年人的毒素介导的剥脱

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Staphylococcal scalded skin syndrome, associated with exfoliative toxin produced by phage group II Staphylococcus aureus, has recently been reported in an adult receiving immunosuppressive therapy. To determine the effect of immunosuppression on the development of the staphylococcal scalded skin syndrome, experimental animals were treated with prednisolone, azathioprine, or a combination of both drugs utilizing the clinical isolate from the adult with scalded skin syndrome. The mean lethal dose and mean exfoliating dose were identical and were 6,000-fold lower in animals receiving both drugs or azathioprine alone. The isolate was not more virulent and did not produce more toxin than other group II phage-type strains. Furthermore, immunosuppressive therapy failed to enhance the susceptibility of experimental animals to a purified preparation of toxin. Finally, purified exfoliative toxin was demonstrated to produce erythema, Nikolsky's sign, bullous formation, and flaking desquamation in a normal human adult. The results demonstrated the enhanced susceptibility of experimental animals receiving immunosuppressive therapy to the development of the staphylococcal scalded skin syndrome. They further showed that human adults are susceptible to the action of exfoliative toxin and suggested that, in the host with compromised defense mechanisms, toxin-producing strains may invade and initiate infection resulting in toxin production and exfoliation.
机译:最近,在接受免疫抑制治疗的成年人中,报告了葡萄球菌烫伤性皮肤综合症,该噬菌体与II型噬菌体金黄色葡萄球菌产生的剥脱性毒素有关。为了确定免疫抑制对葡萄球菌烫伤性皮肤综合症发展的影响,利用泼尼松龙,硫唑嘌呤或两种药物的组合,使用来自患有烫伤性皮肤综合症的成人的临床分离株对实验动物进行治疗。平均致死剂量和平均脱落剂量是相同的,并且在同时接受两种药物或硫唑嘌呤的动物中降低了6000倍。该分离物没有比其他II组噬菌体型菌株更具毒性,并且没有产生更多的毒素。此外,免疫抑制疗法未能增强实验动物对纯化的毒素制剂的敏感性。最后,事实证明,纯净的剥脱性毒素可在正常人中产生红斑,尼古拉斯基征,大疱形成和片状脱屑。结果表明接受免疫抑制治疗的实验动物对葡萄球菌烫伤性皮肤综合症发展的敏感性增加。他们进一步表明,成年人对剥落性毒素的作用敏感,并建议在防御机制受损的宿主中,产毒菌株可能会侵入并引发感染,从而导致毒素产生和剥落。

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