Detection of Multiple Superantigen Genes in Stools of Patients with Kawasaki Disease

Objectives To investigate whether superantigens (SAgs) are involved in the development of Kawasaki disease (KD) by examining SAg genes in the stool of patients with KD. Study design Stool specimens were obtained from 60 patients with KD and 62 age-matched children (36 children with acute illness and 26 healthy children), Total DNA was extracted from these stool samples. Using polymerase chain reaction, we examined genes of 5 SAgs: streptococcal pyrogenic exotoxin-A (SPE-A), SPE-C, SPE-G, SPE-J, and toxic shock syndrome toxin-1. Results At least 1 of the 5 SAg genes was detected in 42 (70%) specimens from patients with KID, 14 (38.9%) from the febrile group, and 7 (26.9%) from the healthy group. The detection rate between subjects with and without KD was of at least 1 of the 5 SAg genes (P < .001), and more than 2 SAg genes were significantly different (P = .002). Conclusions SAg may be involved in the development of KD; data suggest that multiple SAgs may trigger KID. (J Pediatr 2009,155:266-70).