Evaluation of the toxic shock syndrome gene (TSSTI) of Staphylococcus aureus in deceased Neonates of Tehran Forensic Medicine Organization from October 2017 to October 2018

Introduction: Staphylococcus aureus due to the production of toxins such as enterotoxins and toxic shock syndrome toxin (TSST1) can be effective in causing sudden infant death syndrome (SIDS). The present study aimed to identify cases of sudden neonatal deaths and to evaluate the frequency of Staphylococcus aureus in different tissues of neonates referred to Tehran Forensic Medicine Organization during one year as well as quantification of TSST1 toxin and related gene trace in referred samples. Materials and Methods: During the time period from October 2017 to October 2018, 90 samples, including brain, kidney and spleen samples, from SIDS cases referred to forensic medicine organization were studied. A Part of each sample was used for culture and isolation of Staphylococcus aureus and the other part was used for quantitative and qualitative evaluation of TSST1 by ELISA and Real-time PCR. Results and Discussion: 57 cases (63%) out of 90 investigated neonatal deaths, were female and 33 ones (37%) were male. Mortality rate was higher in the 1-6 month age range than other age groups and season had no significant effect. Among the 90 examined samples, only 17 (about 19%) of S. aureus were isolated, all of which were renal. The TSST1 toxin was also detected in only two cases (about 2%), with 1.7 ng in one case and 1.5 ng in the other one. Overall, although the presence of TSST1 toxin in the sample can be considered noteworthy, there was no significant relationship between the presence of this toxin and the occurrence of sudden death syndrome in SIDS cases.