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Vaginal Tampon Colonization by Staphylococcus aureus in Healthy Women

机译：阴道卫星金黄色葡萄球菌在健康女性中的阴道化

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Tampons recovered from a cohort of 737 healthy women (median age, 32?years) were analyzed for the presence of Staphylococcus aureus . A total of 198 tampons (27%) were colonized by S. aureus , 28 (4%) by a strain producing toxic shock syndrome toxin 1 (TSST-1). S. aureus was detected more frequently in tampons that did not require an applicator for their insertion (74/233 [32%] versus 90/381 [24%]; odds ratio [OR]?=?1.51 [95% confidence interval, 1.04 to 2.17]) and in women who used an intrauterine device for contraception (53/155 [34%] versus 145/572 [27%]; OR = 1.53 [95% confidence interval, 1.05 to 2.24]). The S. aureus strains isolated from tampons belonged to 22 different clonal complexes (CCs). The most prevalent CC was CC398 agr 1 ( n ?=?57 [27%]), a clone that does not produce superantigenic toxins, followed by CC30 agr 3 ( n ?=?27, 13%), producing TSST-1 (24/27 [89%]), the principal clone of S. aureus involved in menstrual toxic shock syndrome (MTSS).IMPORTANCE Menstrual toxic shock syndrome (MTSS) is an uncommon severe acute disease that occurs in healthy menstruating women colonized by TSST-1-producing S. aureus who use intravaginal protection, such as tampons and menstrual cups. The catamenial product collected by the protection serves as a growth medium for S. aureus and allows TSST-1 production. Previous studies evaluated the prevalence of genital colonization by S. aureus by vaginal swabbing, but they did not examine tampon colonization. This study demonstrated a high prevalence of tampon colonization by S. aureus and the presence of the CC30 TSST-1 S. aureus clone responsible for MTSS in tampons from healthy women. The results support the vaginal carriage of this lineage in healthy women. In addition, the higher prevalence of S. aureus within tampons that do not require an applicator indicates a crucial role for handwashing before tampon handling to decrease the risk of tampon contamination.
机译：分析了来自737名健康女性（中位年龄，32岁）的卫生棉条恢复为金黄色葡萄球菌的存在。通过菌株产生毒性休克综合征毒素1（TSST-1）的菌株，总共198个培养液（27％）由S.UUREUS，28（4％）定植。在培根中更频繁地检测到金黄色葡萄球菌，其不需要涂抹器的插入（74/233 [32％]与90/381 [24％];赔率比[或]？=？1.51 [95％置信区间， 1.04至2.17]）在使用避孕宫内装置的女性（53/155 [34％]与145/572 [27％];或= 1.53 [95％置信区间，1.05至2.24]）。从卫生棉条中分离的金黄色葡萄球菌菌株属于22种不同的克隆复合物（CCS）。最普遍的CC是CC398 AGR 1（n？=α57[27％]），一种不产生超毒性毒素的克隆，其次是CC30 AGR 3（N？= 27,13％），产生TSST-1（ 24/27 [89％]），涉及月经性毒性休克综合征（MTSS）的金黄色葡萄球菌的主要克隆。分量月经性毒性休克综合征（MTSS）是一种罕见的严重急性疾病，发生在健康的月经妇女中由TSTS- 1生产的金黄色葡萄球菌，他使用静脉内保护，如卫生棉条和月经杯。由保护收集的白痴产品用作S.UUREUS的生长培养基，并允许TST-1生产。以前的研究通过阴道擦拭评估了S.UUREUS的生殖器殖民化的患病率，但它们没有检查卫生棉条殖民化。该研究表明，S. aureus的卫生棉尼殖民化的普及率高，并且CC30 TSST-1S.UUREUS克隆的存在负责来自健康女性的卫生棉条的棉酒。结果支持健康女性这种血统的阴道运输。此外，在不需要涂抹器的卫生棉条内的棉蚜中的患病率较高，表明在卫生棉条处理之前洗手的关键作用，以降低卫生尼污染的风险。

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