Neonatal toxic shock syndrome-like exanthematous disease (NTED)

Pediatr Int. 2003 Apr;45(2):233-7. doi: 10.1046/j.1442-200x.2003.01703.x.

Abstract

The author and colleagues recently discovered an emerging neonatal infectious disease: neonatal toxic shock syndrome-like exanthematous disease (NTED), which is induced by the superantigen toxic shock syndrome toxin-1 (TSST-1), produced by methicillin-resistant Staphylococcus aureus (MRSA). The massively expanded Vbeta2+ T cells were rapidly deleted in the peripheral blood of patients with NTED. A marked depletion of Vbeta2+ T cells was also observed in the peripheral blood before the expansion of these T cells. Anergy is specifically induced in the TSST-1 reactive T cells of patients with NTED. Rapid recovery from NTED without complications is expected to be related to the induction of immunologic tolerance in neonatal patients. Anti-TSST-1 IgG antibody of maternal origin was found to play a protective role in preventing the development of NTED. The number of hospitals that have experience caring for patients with NTED has increased threefold in the past 5 years. Most MRSA isolates from neonatal intensive care units in Japan were found to be a single clone of coagulase type II and to possess TSST-1 and staphylococcal enterotoxin C genes. The timing and increased incidence of NTED suggest the emergence of a new MRSA clone. By recognizing that TSST-1 can induce NTED, healthcare providers may give increased attention to this disease in neonatal wards.

Publication types

  • Review

MeSH terms

  • Antilymphocyte Serum / immunology
  • Bacterial Toxins*
  • Coagulase / immunology
  • Enterotoxins / biosynthesis
  • Enterotoxins / immunology*
  • Exanthema / diagnosis
  • Exanthema / immunology*
  • Humans
  • Infant, Newborn
  • Lymphocyte Activation / immunology
  • Methicillin Resistance / immunology
  • Receptors, Antigen, T-Cell / immunology
  • Shock, Septic / diagnosis
  • Shock, Septic / immunology*
  • Shock, Septic / microbiology*
  • Staphylococcus aureus / immunology*
  • Superantigens / biosynthesis
  • Superantigens / immunology*

Substances

  • Antilymphocyte Serum
  • Bacterial Toxins
  • Coagulase
  • Enterotoxins
  • Receptors, Antigen, T-Cell
  • Superantigens
  • enterotoxin F, Staphylococcal