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Most tampons reduced\n                    <jats:named-content content-type=\"genus-species\">S. aureus<\/jats:named-content>\n                    growth and TSST-1 production, with differences based on brand and composition, and the level of\n                    <jats:named-content content-type=\"genus-species\">S. aureus<\/jats:named-content>\n                    growth was higher in destructured than in unaltered tampons. We observed higher levels of\n                    <jats:named-content content-type=\"genus-species\">S. aureus<\/jats:named-content>\n                    growth and toxin production in menstrual cups than in tampons, potentially due to the additional air introduced into the bag by cups, with differences based on cup composition and size.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>IMPORTANCE<\/jats:bold>\n                    Menstrual toxic shock syndrome is a rare but severe disease. It occurs in healthy women vaginally colonized by\n                    <jats:named-content content-type=\"genus-species\">Staphylococcus aureus<\/jats:named-content>\n                    producing toxic shock syndrome toxin 1 using intravaginal protection, such as tampons or menstrual cups. Intravaginal protection induces TSS by the collection of catamenial products, which act as a growth medium for\n                    <jats:named-content content-type=\"genus-species\">S. aureus<\/jats:named-content>\n                    . Previous studies evaluated the impact of tampon composition on\n                    <jats:named-content content-type=\"genus-species\">S. aureus<\/jats:named-content>\n                    producing toxic shock syndrome toxin 1, but they are not recent and did not include menstrual cups. This study demonstrates that highly reproducible results for\n                    <jats:named-content content-type=\"genus-species\">S. aureus<\/jats:named-content>\n                    growth and TSST-1 production can be obtained by using a simple protocol that reproduces the physiological conditions of tampon and cup usage as closely as possible, providing recommendations for tampon or cup use to both manufacturers and consumers. Notably, our results do not show that menstrual cups are safer than tampons and suggest that they require similar precautions.\n                  <\/jats:p>","DOI":"10.1128\/aem.00351-18","type":"journal-article","created":{"date-parts":[[2018,4,18]],"date-time":"2018-04-18T05:01:23Z","timestamp":1524027683000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":56,"title":["Impact of Currently Marketed Tampons and Menstrual Cups on Staphylococcus aureus Growth and Toxic Shock Syndrome Toxin 1 Production\n                    <i>In Vitro<\/i>"],"prefix":"10.1128","volume":"84","author":[{"given":"Louis","family":"Nonfoux","sequence":"first","affiliation":[{"name":"Centre International de Recherche en Infectiologie, Inserm U1111, Universit\u00e9 Lyon 1, Ecole Normale Sup\u00e9rieure de Lyon, CNRS UMR 5308, Lyon, 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