Vaginal isolates of Staphylococcus aureus associated with toxic shock syndrome.

Staphylococcus aureus has been isolated from vaginal fluids of women with toxic shock syndrome (TSS), a multisystem disease with onset usually during menses. A total of 15 vaginal isolates of S. aureus from TSS patients were compared with 18 vaginal isolates from women without TSS. Phenotypic traits which were significantly more frequent in the TSS group of strains than in the non-TSS group were arsenate resistance, proteolysis of hemoglobin, reduced hemolysis of sheep blood in agar medium, and lack of lethality of culture filtrates for chicken embryos and rabbits. In addition, isoelectric focusing of ethanol extracts of culture filtrates showed differences between the two groups in the occurrence of two proteins. All hemolytic and chicken embryo-lethal strains (3 TSS strains and 14 non-TSS strains) produced an extracellular protein with an isoelectric point of 8.6. In contrast, all TSS strains, but only one-half of non-TSS strains, released a protein with an isoelectric point of 7.0 and an apparent subunit molecular weight of 22,000.