NMTSSNational Meeting, Training and Seminar System (Market America; Greensboro, NC)
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Most pediatric nmTSS cases were related to burns (26.8%, 15/56) or SSTIs (25%, 14/56).
We found no difference in fatality rate between mTSS and nmTSS cases and no association with age (online Technical Appendix Table 2).
The leading cause of both mTSS and nmTSS was CC30 MSSA, accounting for >50% of infections (Figure 3), although we found a stronger association of CC30 with mTSS than with nmTSS (72.9% vs.
The most common superantigen gene among both mTSS and nmTSS isolates was tst (Table 2; online Technical Appendix Figure 2), with the exception of the other 2 prevalent superantigen genes, seg and sei, that are carried on an enterotoxin gene cluster (egc) along with selm/n/o/u in most S.
TSS incidence was 0.07/100,000 population, nmTSS cases now outnumber mTSS cases, and nmTSS affects younger persons.
The number of cases of mTSS fell from 2009 to 2012, such that nmTSS cases are now more common than mTSS cases, mirroring US trends (31).
Menstrual TSS (mTSS) is more prevalent than nonmenstrual TSS (nmTSS)
Patients with nmTSS were older than those with mTSS and had higher mortality rates
Toxic shock syndrome toxin 1 (TSST-1) producing (tst+) CC30 lineage methicillin-sensitive Staphylococcus aureus (MSSA) strains were the leading cause of mTSS but not nmTSS
mTSS, menstrual TSS; nmTSS, nonmenstrual TSS; TSS, toxic shock syndrome.