{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T01:36:02Z","timestamp":1790818562541,"version":"4.1.0"},"reference-count":36,"publisher":"American Society for Microbiology","issue":"5","license":[{"start":{"date-parts":[[2010,5,1]],"date-time":"2010-05-01T00:00:00Z","timestamp":1272672000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Clin Vaccine Immunol"],"published-print":{"date-parts":[[2010,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Staphylococcal toxic shock syndrome toxin 1 (TSST-1) is the cause of menstrual toxic shock syndrome (mTSS) associated with vaginal colonization by\n            <jats:italic>Staphylococcus aureus<\/jats:italic>\n            . In this pilot study, we measured TSST-1 and alpha-toxin, another exotoxin, on used tampons from four healthy women with\n            <jats:italic>S. aureus<\/jats:italic>\n            on tampons and from two women with tampon-associated mTSS. Tampons from all six women were sectioned into approximately 0.5-cm\n            <jats:sup>3<\/jats:sup>\n            pieces, some containing menstrual blood and some lacking menstrual blood. The pH of tampon sections with or without menstrual blood was neutral.\n            <jats:italic>S. aureus<\/jats:italic>\n            CFU were present in tampon sections at approximately equivalent counts (total counts were 1 \u00d7 10\n            <jats:sup>8<\/jats:sup>\n            to 2 \u00d7 10\n            <jats:sup>9<\/jats:sup>\n            CFU\/tampon). TSST-1 (2 to 80 \u03bcg\/tampon) and alpha-toxin (28 to 30 \u03bcg\/tampon) were present only in the sections containing little or no menstrual blood (low hemoglobin density). In the tampons from TSS patients, the cytokine gamma interferon (IFN-\u03b3) was detected only in menstrual-blood-containing sections, whereas the chemokines macrophage inflammatory protein 3\u03b1 and interleukin-8 were detected in all sections. Thus, IFN-\u03b3 was being produced systemically, whereas the chemokines were being produced both locally by epithelial cells and systemically. The data show that\n            <jats:italic>S. aureus<\/jats:italic>\n            exotoxins can be identified in tampons\n            <jats:italic>ex vivo<\/jats:italic>\n            in sites with low hemoglobin density.\n          <\/jats:p>","DOI":"10.1128\/cvi.00483-09","type":"journal-article","created":{"date-parts":[[2010,3,25]],"date-time":"2010-03-25T03:29:05Z","timestamp":1269487745000},"page":"722-727","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":39,"title":["<i>Staphylococcus aureus<\/i>\n            Exotoxins Are Present\n            <i>In Vivo<\/i>\n            in Tampons"],"prefix":"10.1128","volume":"17","author":[{"given":"Patrick M.","family":"Schlievert","sequence":"first","affiliation":[{"name":"Department of Microbiology, Medical School"},{"name":"Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota 55455"},{"name":"the Procter &amp; Gamble Company, Cincinnati, Ohio 45224"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly A.","family":"Nemeth","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Medical School"},{"name":"Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota 55455"},{"name":"the Procter &amp; Gamble Company, Cincinnati, Ohio 45224"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine C.","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Medical School"},{"name":"Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota 55455"},{"name":"the Procter &amp; Gamble Company, Cincinnati, Ohio 45224"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marnie L.","family":"Peterson","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Medical School"},{"name":"Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota 55455"},{"name":"the Procter &amp; Gamble Company, Cincinnati, Ohio 45224"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce E.","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Medical School"},{"name":"Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota 55455"},{"name":"the Procter &amp; Gamble Company, Cincinnati, Ohio 45224"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","first-page":"1017","year":"1981","unstructured":"Bergdoll, M. 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