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. 1995 Oct;48(10):929–932. doi: 10.1136/jcp.48.10.929

Lethal synergy between toxins of staphylococci and enterobacteria: implications for sudden infant death syndrome.

N M Sayers 1, D B Drucker 1, J A Morris 1, D R Telford 1
PMCID: PMC502949  PMID: 8537492

Abstract

AIM--To test the hypothesis that lethal synergy occurs between toxin preparations of nasopharyngeal staphylococci and enterobacteria from sudden infant death syndrome (SIDS) victims and matched healthy infants. METHODS--SIDS and matched healthy babies were studied if both staphylococcal and enterobacterial strains were isolated from the nasopharynx. The lethality of toxin preparations from each bacterial isolate (separately and combined) was assessed over a range of dilutions using the chick embryo assay system. RESULTS--Staphylococci and enterobacteria were isolated together from the nasopharynx of seven SIDS babies but from only one normal healthy infant. Enterobacterial toxins were lethal at high dilutions. Staphylococcal toxins were less toxic. Simultaneous testing in the chick assay of staphylococcal and enterobacterial toxins, from each baby, at non-lethal concentrations enhanced lethality levels by 177 to 1011% compared with lethality expected by an additive effect alone. CONCLUSIONS--Synergy occurs between the toxins of nasopharyngeal staphylococci and enterobacteria. This combination of strains is more likely to occur in the nasopharynx of SIDS victims than that of healthy infants.

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Selected References

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  1. Beckwith J. B. The sudden infant death syndrome. Curr Probl Pediatr. 1973 Jun;3(8):1–36. [PubMed] [Google Scholar]
  2. Beezhold D. H., Best G. K., Bonventre P. F., Thompson M. Synergistic induction of interleukin-1 by endotoxin and toxic shock syndrome toxin-1 using rat macrophages. Infect Immun. 1987 Dec;55(12):2865–2869. doi: 10.1128/iai.55.12.2865-2869.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bentele K. H., Albani M. Are there tests predictive for prolonged apnoea and SIDS? A review of epidemiological and functional studies. Acta Paediatr Scand Suppl. 1988;342:1–21. doi: 10.1111/j.1651-2227.1988.tb10792.x. [DOI] [PubMed] [Google Scholar]
  4. Bettelheim K. A., Goldwater P. N., Dwyer B. W., Bourne A. J., Smith D. L. Toxigenic Escherichia coli associated with sudden infant death syndrome. Scand J Infect Dis. 1990;22(4):467–476. doi: 10.3109/00365549009027079. [DOI] [PubMed] [Google Scholar]
  5. Brooks J. G. Apnea of infancy and sudden infant death syndrome. Am J Dis Child. 1982 Nov;136(11):1012–1023. doi: 10.1001/archpedi.1982.03970470056016. [DOI] [PubMed] [Google Scholar]
  6. Drucker D. B., Aluyi H. A., Morris J. A., Telford D. R., Oppenheim B. A., Crawley B. A. Possibility of separating toxins from bacteria associated with sudden infant death syndrome using anion exchange chromatography. J Clin Pathol. 1992 Sep;45(9):802–805. doi: 10.1136/jcp.45.9.802. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Drucker D. B., Aluyi H. S., Morris J. A., Telford D. R., Gibbs A. Lethal synergistic action of toxins of bacteria isolated from sudden infant death syndrome. J Clin Pathol. 1992 Sep;45(9):799–801. doi: 10.1136/jcp.45.9.799. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Eichhorn E. A. A TECHNIQUE FOR THE INTRAVENOUS INOCULATION OF CHICK EMBRYOS. Science. 1940 Sep 13;92(2385):245–246. doi: 10.1126/science.92.2385.245. [DOI] [PubMed] [Google Scholar]
  9. Hinder F., Schmidt A., Gong J. H., Bender A., Sprenger H., Nain M., Gemsa D. Influenza A virus infects macrophages and stimulates release of tumor necrosis factor-alpha. Pathobiology. 1991;59(4):227–231. doi: 10.1159/000163651. [DOI] [PubMed] [Google Scholar]
  10. Holland I. B., Kenny B., Blight M. Haemolysin secretion from E coli. Biochimie. 1990 Feb-Mar;72(2-3):131–141. doi: 10.1016/0300-9084(90)90138-7. [DOI] [PubMed] [Google Scholar]
  11. Jakeman K. J., Rushton D. I., Smith H., Sweet C. Exacerbation of bacterial toxicity to infant ferrets by influenza virus: possible role in sudden infant death syndrome. J Infect Dis. 1991 Jan;163(1):35–40. doi: 10.1093/infdis/163.1.35. [DOI] [PubMed] [Google Scholar]
  12. Kandall S. R., Gaines J., Habel L., Davidson G., Jessop D. Relationship of maternal substance abuse to subsequent sudden infant death syndrome in offspring. J Pediatr. 1993 Jul;123(1):120–126. doi: 10.1016/s0022-3476(05)81554-9. [DOI] [PubMed] [Google Scholar]
  13. Law D., Ganguli L. A., Donohue-Rolfe A., Acheson D. W. Detection by ELISA of low numbers of Shiga-like toxin-producing Escherichia coli in mixed cultures after growth in the presence of mitomycin C. J Med Microbiol. 1992 Mar;36(3):198–202. doi: 10.1099/00222615-36-3-198. [DOI] [PubMed] [Google Scholar]
  14. Lee S., Barson A. J., Drucker D. B., Morris J. A., Telford D. R. Lethal challenge of gnotobiotic weanling rats with bacterial isolates from cases of sudden infant death syndrome (SIDS). J Clin Pathol. 1987 Dec;40(12):1393–1396. doi: 10.1136/jcp.40.12.1393. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Li D. K., Daling J. R. Maternal smoking, low birth weight, and ethnicity in relation to sudden infant death syndrome. Am J Epidemiol. 1991 Nov 1;134(9):958–964. doi: 10.1093/oxfordjournals.aje.a116180. [DOI] [PubMed] [Google Scholar]
  16. Lundemose J. B., Smith H., Sweet C. Cytokine release from human peripheral blood leucocytes incubated with endotoxin with and without prior infection with influenza virus: relevance to the sudden infant death syndrome. Int J Exp Pathol. 1993 Jun;74(3):291–297. [PMC free article] [PubMed] [Google Scholar]
  17. Marrack P., Kappler J. The staphylococcal enterotoxins and their relatives. Science. 1990 May 11;248(4956):705–711. doi: 10.1126/science.2185544. [DOI] [PubMed] [Google Scholar]
  18. McKendrick N., Drucker D. B., Morris J. A., Telford D. R., Barson A. J., Oppenheim B. A., Crawley B. A., Gibbs A. Bacterial toxins: a possible cause of cot death. J Clin Pathol. 1992 Jan;45(1):49–53. doi: 10.1136/jcp.45.1.49. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Milner A. D. Recent theories on the cause of cot death. Br Med J (Clin Res Ed) 1987 Nov 28;295(6610):1366–1368. doi: 10.1136/bmj.295.6610.1366. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Morris J. A., Haran D., Smith A. Hypothesis: common bacterial toxins are a possible cause of the sudden infant death syndrome. Med Hypotheses. 1987 Feb;22(2):211–222. doi: 10.1016/0306-9877(87)90145-9. [DOI] [PubMed] [Google Scholar]
  21. Schlievert P. M. Alteration of immune function by staphylococcal pyrogenic exotoxin type C: possible role in toxic-shock syndrome. J Infect Dis. 1983 Mar;147(3):391–398. doi: 10.1093/infdis/147.3.391. [DOI] [PubMed] [Google Scholar]
  22. Telford D. R., Morris J. A., Hughes P., Conway A. R., Lee S., Barson A. J., Drucker D. B. The nasopharyngeal bacterial flora in the sudden infant death syndrome. J Infect. 1989 Mar;18(2):125–130. doi: 10.1016/s0163-4453(89)91094-3. [DOI] [PubMed] [Google Scholar]
  23. Valdes-Dapena M. A. Sudden and unexpected death in infancy: a review of the world literature 1954-1966. Pediatrics. 1967 Jan;39(1):123–138. [PubMed] [Google Scholar]
  24. Wieneke A. A. The detection of enterotoxin and toxic shock syndrome toxin-1 production by strains of Staphylococcus aureus with commercial RPLA kits. Int J Food Microbiol. 1988 Aug;7(1):25–30. doi: 10.1016/0168-1605(88)90069-4. [DOI] [PubMed] [Google Scholar]
  25. Williams A. L. Sudden infant death syndrome. Aust N Z J Obstet Gynaecol. 1990 May;30(2):98–107. doi: 10.1111/j.1479-828x.1990.tb03235.x. [DOI] [PubMed] [Google Scholar]
  26. Williams A. L., Uren E. C., Bretherton L. Respiratory viruses and sudden infant death. Br Med J (Clin Res Ed) 1984 May 19;288(6429):1491–1493. doi: 10.1136/bmj.288.6429.1491. [DOI] [PMC free article] [PubMed] [Google Scholar]

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