Postoperative toxic shock syndrome caused by a highly virulent methicillin-resistant Staphylococcus aureus strain.

We report on a rare fatal case of postoperative toxic shock syndrome caused by infection with a highly virulent methicillin-resistant Staphylococcus aureus strain, designated Sak-1, which was found to be characteristic in its increased production of toxic shock syndrome toxin 1 in human whole blood (about 30-fold more than produced in Tod Hewitt broth). The strain also produced a high level of toxic shock syndrome toxin 1 in the circulating blood of mice experimentally infected with the strain.