Possible mechanisms for vaginal infection with Staphylococcus aureus: inferences drawn from studies of nosocomial infection of newborn infants and surgical patients.

Previous epidemiologic studies of staphylococcal infections in newborn infants and surgical patients provide clues to the method of infection in toxic shock syndrome. In newborn infants, staphylococci were shown to be transmitted most often by the hands of nursery personnel to the umbilical stump, which afforded a warm, moist milieu for bacterial growth. Studies indicated that many surgical wound infections were due to the patients' own organisms, which were carried into the operating room on the patient's skin. It is hypothesized that in toxic shock syndrome the tampon becomes contaminated with a staphylococcal strain from the woman's own hands or skin during the process of insertion. With menstrual blood retained by the tampon in the warm vagina acting as a culture medium, the organism multiplies and elaborates toxin.