Certain bacteria may suppress toxic shock toxin
Certain Streptococci can increase their production of the toxin to potentially dangerous levels in the presence of aerobic bacteria in the vagina, according to the study. Gregor Reid, the principal investigator of the study, and his colleagues published their findings in Applied and Environmental Microbiology.
"The risk of potentially fatal toxic shock syndrome appears to be influenced by the types of bacteria present in the vagina," Reid said. "I figured that the Staphylococcus aureus strains with the ability to produce toxic shock syndrome toxin might only do this under certain environmental conditions. In the vagina, that means depending on pH and the other bacteria living there."
The researchers took swabs from women with bacterial vaginosis, with intermediate vaginal health and with clinically healthy vaginal status. Reid's team identified the bacterial species and assayed for toxic shock syndrome toxin 1. The team found that Streptococcus agalactiae, also known as Group B streptococci, increased the production of the toxin 3.7 fold.
Some species had the opposite effect, including one species of lactobacillus that repressed toxin production by 72 percent.
"These experiments emphasize that for proper clinical care of women, we need to know all bacterial types present in the vagina," Reid said. "Culturing is inadequate, and while some microscopy is feasible if the viewer develops the expertise to assess the vaginal smears, rapid 16s sequencing systems are needed as a diagnostic tool, (because many species are) very difficult to culture (or have never been cultured)."
Reid said scientists must update how bacterial infections are diagnosed in women and how to treat them with new probiotics.
"We need to vastly improve how we diagnose infections and determine the risk of infection of women. (We must also improve) our ability to manipulate microbiota (with probiotics) in lieu of using broad spectrum antibiotics that were developed 40 years ago, and are not very effective in the vagina, and certainly not designed to neutralize toxins."