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The potential role of bacterial toxins in Sudden Infant Death Syndrome (SIDS)

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Summary

Toxigenic bacteria have been implicated in some cases of Sudden Infant Death Syndrome (SIDS). Although there is not much evidence thatClostridia spp. are associated with SIDS in Britain, strains ofStaphylococcus aureus producing pyrogenic toxins have been isolated from significant numbers of these infants at autopsy. The pyrogenic toxins, produced by some strains of group AStreptococcus pyogenes as well as staphylococci, are powerful “superantigens” that have significant physiological effects including induction of fever > 38°C. In this article, interactions between genetic and environmental factors that might enhance colonization of epithelial surfaces by toxigenic staphylococci are analyzed: infant's expression of Lewisa antigen which acts as a receptor for some microorganisms; viral infections; the effect of mother's smoking on susceptibility to respiratory infection. Based on epidemiological findings and laboratory investigations, a hypothesis is proposed to explain how bacteria producing pyrogenic toxins might contribute to some cot deaths.

Zusammenfassung

In einigen Fällen des Sudden Infant Death Syndrom (SIDS) wurde die Rolle Toxin bildender Bakterien diskutiert. Obwohl es keinen Beweis gibt, daß Clostridia spp. mit SIDS in Großbritanien assoziiert sind, sind von signifikanter Anzahl dieser Kinder bei der Autopsie Stämme von Stapylokkokus aureus isoliert worden, welche Fieber erzeugende Toxine produzieren. Die Fieber erzeugenden Toxine, welche von einigen Stämmen der Gruppe A Streptokkokus pyogenes produziert werden, wie auch von Staphylokkoken, sind mächtige „Superantigene”, welche signifikante physiologische Effekte haben unter Einbeziehung der Induktion von Fieber mit mehr als 38°C. In diesem Artikel werden Interaktionen zwischen genetischen und Umgebungsfaktoren erörtert, welche die Kolonisierung epithelialer Oberflächen durch Toxin bildende Staphylokkoken steigern könnten: die Expression des Lewisa Antigens des Kindes, welches als Rezeptor für einige Mikroorganismen wirksam ist; virale Infektionen; die Auswirkung des mütterlichen Rauchens auf die Empfänglichkeit für Atemwegsinfektionen. Basierend auf epidemiologischen Befunden und Laboratoriumsuntersuchungen wird eine Hypothese vorgeschlagen, wie Bakterien; welche pyrogene Toxine produzieren, zu einigen plötzlichen Kindstodesfällen beitragen könnten.

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Authors and Affiliations

  1. Department of Medical Microbiology, Department of Pathology, University of Edinburgh, Medical School, Teviot Place, EH8 9AG, Edinburgh, UK

    C. C. Blackwell, A. T. Saadi, M. W. Raza & D. M. Weir

  2. Forensic Medicine Unit, Department of Pathology, University of Edinburgh, Medical School, Teviot Place, EH8 9AG, Edinburgh, UK

    A. Busuttil

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  1. C. C. Blackwell
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  2. A. T. Saadi
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  3. M. W. Raza
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  4. D. M. Weir
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Blackwell, C.C., Saadi, A.T., Raza, M.W. et al. The potential role of bacterial toxins in Sudden Infant Death Syndrome (SIDS). Int J Leg Med 105, 333–338 (1993). https://doi.org/10.1007/BF01222118

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  • DOI: https://doi.org/10.1007/BF01222118

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