Risk involvement with Staphylococcus aureus exotoxins among pyogenic skin infections with special reference to toxic shock syndrome.

The sera of three patients involved in a non-menstrual toxic shock syndrome outbreak showed TSST-1 at a concentration above 40 ng/ml and no antibodies of IgG class against the toxin. A Staphylococcus aureus strain producing TSST-1 was isolated from one of the patients. S. aureus strains showing similar phage type and biotype patterns were isolated from 473 out of 876 close contacts with the patients involved in this outbreak. This carriage and spread was traced to pyogenic skin infections (mainly "folliculitis") among this population. Serological studies indicated that during the early phase of the outbreak anti TSST-1 titres were low then rose gradually. In a further related study the frequency of enterotoxin production was found 48.5% among staphylococci isolated from pyogenic skin infections. Our data indicated that pyogenic skin infections are potential source for toxic shock syndrome.

Incidence of enterotoxin producing Staphylococcus aureus among pyogenic skin infections.

Out of the total 68 S. aureus strains isolated and studied from pyoderma patients, 33 (48.5%) strains produced enterotoxin. Isolates from IED, impetigo and folliculitis exhibited high degree of enterotoxigenicity. SE-C and its combinations with other enterotoxins was common. 60.6% of the SE producers were found phage nontypable. Typable enterotoxigenic strains were associated with III, IV and mixed phage groups. S. aureus var. hominis and S. aureus var. bovis are the prevalent subspecies types and potent SE producers among pyogenic skin infections.

Epidemiological patterns and incidence of bio-, sero- and phage types of Vibrio cholerae in Hyderabad, India, during 1971-1984.

During 1971-1984 out of 44,762 gastroenteritis cases bacteriologically examined, 4240 (9.5%) Vibrio cholerae were isolated in Hyderabad, India. Out of them 1329 (31.3%) were classical and 2911 (68.7%) were el-tor biotypes. The changeover from classical to el-tor cholera was observed in Hyderabad during 1975 and persisted. During this 14 year period four major outbreaks with V. cholerae serogroup O1 Ogawa, V. cholerae biotype el-tor serogroup O1 Ogawa were observed. Phage types 1, 2 and 4 were prevalent during the classical period and types 2 and 4 during the el-tor period. Of the cholera patients, 67% were under 30 years of age with no significant difference in the incidence among females (51.4%) and males (48.6%). The outbreaks were of protracted pattern with only few cases per day or week with peak incidence during monsoon (May-August). Community of the low socio-economic strata was the most susceptible group. Five zones situated at the outlet of the Moosi river in the downhill were recorded as extensive cholera transmission zones and two of them were the primary foci of infection. The severity of the infection was found directly related to the average rainfall during the year leading to the sewage stagnation in the downhill.

Production of toxic shock syndrome toxin-1 (TSST-1) associated with Staphylococcus aureus from a pyogenic skin infection.

Toxic Shock Syndrome Toxin-1 (TSST-1) producing Staphylococcus aureus associated with TSS was isolated from an abscess on buttock, from a two-year-old male child suffering from diarrhoea, high fever and shock. The isolate was subclassified into S. aureus var. hominis of CV type-D, and was lysed by phage 75 of Group-III. It was multidrug resistant, exhibited double ring (DR) CVRT pattern and also produced enterotoxin-C (SE-C). Out of 217 S. aureus strains from pyodermas, clinical sources, food poisonings and dairy foods, 139 (64.1%) produced enterotoxin. SE-C as single (33.8%) or in combinations (25.2%) was common enterotoxin. None of these strains produced TSST-1.

Prevalence of staphylococcal zoonosis in pyogenic skin infections.

S. aureus aetiology was found in 76.47% of the 102 pyoderma cases under study, with a high frequency of incidence in children below 5 years of age. The majority of the S. aureus isolates was nontypable (50.0%) and among the typable strains, phage group-III (31.0%), Group-I (20.7%) and a mixed phage group (34.5%) were predominant. 28.2% of the isolates were S. aureus var. bovis and 2.6% were S. aureus var. canis subgroups. Zoonoses in staphylococcal pyogenic skin infections were proved in 9 of the cases, which showed the history of direct animal contact supported by the isolation of S. aureus of animal host origin. Dogs, cattle and poultry were found to be the most important reservoirs transmitting S. aureus to humans, with folliculitis, furunculosis, impetigo as the frequent clinical manifestations.

Excessive ingestion of fluoride and the significance of sialic acid: glycosaminoglycans in the serum of rabbit and human subjects.

The levels of sialic acid and glycosaminoglycans were explored in the sera of rabbit and human subjects who ingested fluoride and had clinical manifestation of fluorosis. Changes observed in the level of these chemical constituents in sera possibly reflect changes occurring in calcified and noncalcified tissues due to fluoride intoxication. The ratio of sialic acid content vs glycosaminoglycans revealed there was a 50% reduction in rabbit and human sera. The test is recommended for evaluating the prognosis of fluoride poisoning/fluorosis.