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. 1988 Feb;26(2):279–282. doi: 10.1128/jcm.26.2.279-282.1988

Delta toxin activity in coagulase-negative staphylococci from the bowels of neonates.

D W Scheifele 1, G L Bjornson 1
PMCID: PMC266267  PMID: 3343323

Abstract

Coagulase-negative staphylococci are prominent in stools of neonates in some intensive care units and have been associated with necrotizing enterocolitis. A plausible mediator of bowel damage is delta-like toxin, which is produced in vitro by most coagulase-negative staphylococci, but factors influencing the expression of toxin in the bowel are unknown. We examined 105 coagulase-negative staphylococcus isolates from stools of neonates by using an enzyme-linked immunosorbent assay and detected delta toxin production by 92 isolates (88%). The amount present in 18-h broth cultures varied over 100-fold, from 933 to 125,000 ng/ml. All broths positive by enzyme-linked immunosorbent assay except one caused hemolysis of human erythrocytes. The threshold concentration for consistent cytotoxicity to fibroblasts was greater than or equal to 24,000 ng/ml. Only 56% of Staphylococcus epidermidis isolates were capable of producing this much toxin, and these were more often obtained from premature infants in intensive care than from healthy full-term infants (P = 0.003) and were more often resistant to multiple antibiotics (P less than 0.001). Cultures grown anaerobically seldom caused hemolysis (4 positive of 29 tested; P less than 0.001) because potency of the toxin was decreased (at least ninefold for S. epidermidis isolates). We conclude that only a portion of the fecal coagulase-negative staphylococci tested produced enough delta toxin in vitro to be cytotoxic, that such isolates have accumulated in our intensive care nursery, and that development of toxin-mediated bowel injury may also require a favorable redox potential within the host bowel.

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Selected References

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