Journal Article

Immunogenicity of Toxins during <i>Staphylococcus aureus</i> Infection

Nelianne J. Verkaik, Olivier Dauwalder, Kenza Antri, Ilhem Boubekri, Corné P. de Vogel, Cédric Badiou, Michèle Bes, Francçois Vandenesch, Mohamed Tazir, Herbert Hooijkaas, Henri A. Verbrugh, Alex van Belkum, Jerome Etienne, Gerard Lina, Nadjia Ramdani-Bouguessa and Willem J.B. van Wamel

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 50, issue 1, pages 61-68
Published in print January 2010 | ISSN: 1058-4838
Published online January 2010 | e-ISSN: 1537-6591 | DOI:
Immunogenicity of Toxins during Staphylococcus aureus Infection

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  • Infectious Diseases
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Toxins are important Staphylococcus aureus virulence factors, but little is known about their immunogenicity during infection. Here, additional insight is generated.


Serum samples from 206 S. aureus-infected patients and 201 hospital-admitted control subjects were analyzed for immunoglobulin (Ig) G binding to 20 toxins, using flow-cytometry based technology. Antibody levels were associated with polymerase chain reaction-defined presence of toxin genes in homologous S. aureus isolates.


IgG levels directed to exfoliative toxin (ET) A, ETB, ghemolysin B (HlgB), leukocidin (Luk) D, LukE, LukS, staphylococcal enterotoxin (SE) A, SEE, SEH, SEI, and SElM were higher in S. aureus-infected patients than in control subjects (P <.05). Furthermore, in the S. aureus-infected patient group, IgG levels were higher if genes encoding ETA, ETB, SEA, SEC, SEH, SElQ, toxic shock syndrome toxin-1 (TSST-1), or Panton-Valentine leukocidin (PVL) were present in the infectious isolate (P < .05). Levels of anti-SEA IgG increased during infections with sea-positive (median fluorescence intensity from 11,555 to 12,388; P<.05) but not sea-negative strains. In addition, anti-LukS IgG levels increased during skin and soft-tissue infections with luk-PV-positive (median fluorescence intensity from 15,231 to 15,911; P < .05) but not luk-PV-negative strains. Bacteremia was associated with sea (odds ratio, 3.4; 95% confidence interval, 1.2–10.0) and tst (odds ratio, 5.7; 95% confidence interval, 1.6–20.8). Skin and soft-tissue infections and bone and joint infections were associated with luk-PV (odds ratio, 2.5; 95% confidence interval, 1.2–5.2).


Many toxins are expressed in vivo and recognized by the immune system during staphylococcal infections, suggesting their involvement in S. aureus pathogenesis.

Journal Article.  5273 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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