Epidemiological investigation of exfoliative toxin-producing Staphylococcus aureus strains in hospitalized patients.

The incidence of exfoliative toxin-producing strains of Staphylococcus aureus was studied. Samples from hospitalized patients of all ages and samples from infants less than 6 weeks old were screened; out of 2,632 coagulase-positive S. aureus strains tested, 6.2% synthesized exfoliative toxin. The clinical features could be assessed in 86 patients harboring exfoliative toxin-producing staphylococci. Skin lesions (pustules, blisters, and bullous impetigo) could be observed only when the exfoliative toxin-positive strains were isolated from the skin. Phage nongroup II strains seemed less skin pathogenic than phage group II strains. Outbreaks and sporadic cases were observed.