Original Article

Ann Lab Med 2015; 35(1): 89-93

Published online January 1, 2015

Copyright © Korean Society for Laboratory Medicine.

Prevalence of Antibody to Toxic Shock Syndrome Toxin-1 in Burn Patients

Ji-Young Park, M.D.1, Jae-Seok Kim, M.D.1, and Heungjeong Woo, M.D.2

Departments of Laboratory Medicine1 and Internal Medicine2, Hallym University College of Medicine, Chuncheon, Korea

Correspondence to: Jae-Seok Kim
Department of Laboratory Medicine, Hallym University College of Medicine, Kangdong Sacred Heart Hospital, 150 Sunganro-gil, Gangdong-gu, Seoul 134-701, Korea
Tel: +82-2-2224-2327
Fax: +82-2-2224-2214
Heungjeong Woo
Department of Internal Medicine, Hallym University College of Medicine, Dongtan Sacred Heart Hospital, 7 Keunjaebong-gil, Hwaseong 445-907, Korea
Tel: +82-31-8086-2385

Received: July 14, 2014; Revised: September 24, 2014; Accepted: November 1, 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background: Burn wounds lack normal barriers that protect against pathogenic bacteria, and burn patients are easily colonized and infected by Staphylococcus aureus. Toxic shock syndrome (TSS) is a rare but fatal disease caused by S. aureus. A lack of detectable antibodies to TSS toxin-1 (TSST-1) in serum indicates susceptibility to TSS. Methods: A total of 207 patients (169 men and 38 women; median age, 42.5 yr) admitted to a burn center in Korea were enrolled in this study. The serum antibody titer to TSST-1 was measured by sandwich ELISA. S. aureus isolates from the patients’ nasal swab culture were tested for TSST-1 toxin production by PCR-based detection of the TSST-1 toxin gene. Results: One hundred seventy-four (84.1%) patients showed positive results for antibody against TSST-1. All patients aged ≥61 yr (n=28) and <26 months (n=7) were positive for the anti-TSST-1 antibody. S. aureus was isolated from 70 patients (33.8%), and 58.6% of the isolates were methicillin resistant. Seventeen patients were colonized with TSST-1-producing S. aureus. The antibody positivity in these 17 carriers was 88.2%, and the positivity in the non-carriers was 83.7%. Conclusions: Most burn patients had antibody to TSST-1, and nasal colonization with TSST-1-producing S. aureus was associated with positive titers of anti-TSST-1 antibody. Additionally, patients with negative titers of anti-TSST-1 antibody might be susceptible to TSS.

Keywords: Burns, Toxic shock syndrome, Toxic shock syndrome toxin-1, Staphylococcus aureus, Antibodies, Prevalence