Original ArticlesPrevalence of superantigen-secreting bacteria in patients with Kawasaki disease☆,☆☆
Section snippets
Study populations
The institutional review board of each institution approved this study. Patients were enrolled between February 1998 and March 2000 at 6 sites: Arkansas Children's Hospital, New England Medical Center at Tufts University School of Medicine, Children's Memorial Hospital at Northwestern University Medical School, Children's Hospital in Denver, Texas Children's Hospital at Baylor College of Medicine, and Children's Hospital of Los Angeles. Patients who presented with classic features of KD as
Results
The present study characterized bacterial cultures from 45 patients with untreated acute KD and 37 febrile control patients seen at 6 geographically diverse institutions (Table I).The demographics of patients are shown in Table II.Empty Cell KD Control patients No. of patients 45 37 Sex (male:female) 27:18 21:16 Mean age (range) mo 37.3 (5–96) 36.6 (5–84) Ethnic distribution (C:AA:H:A) 20:7:10:8 14:13:8:2 TSST-producing S aureus 18 7 SEB-producing S aureus
Discussion
Data supporting the hypothesis that superantigens play a role in the cause of KD have been conflicting. For example, several reports have described an expansion of T-cell receptor (TCR) V β2+ T-lymphocytes in patients with acute KD.15, 16, 17, 18, 19, 20 Skewing of Vβ T-lymphocytes is one of the hallmarks of superantigen stimulation. In at least one study, the V-β2 expansion was found to be polyclonal, which is consistent with a superantigen-mediated stimulation.16 However, other reports have
Acknowledgements
We thank Maureen Plourd-Sandoval for her assistance in the preparation of the manuscript and Linda K. Perry for expert technical assistance.
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Supported in part by USPHS grants HL-37260, HL-36611, AR-41256, AR-37070, AI-28495, and AI-28495 from the National Institutes of Health, and the Ann and Louis Rudolph Kawasaki Disease Research Fund.
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Reprint requests: H. Cody Meissner, MD, Pediatric Infectious Disease, New England Medical Center, 750 Washington St, Boston, MA 02111.