Increased incidence of menstruation-associated bactericidal defects in neutrophils from women who have recovered from toxic shock syndrome

There is a growing suspicion that a host abnormality may contribute to the pathogenesis of toxic shock syndrome (TSS). We found that females (5 of 5) who had recovered from TSS had transient, menstruation-associated decreases (≥9%) in the ability of their neutrophils to killStaphylococcus aureus, 502A in vitro more often (P=0.040 by Fisher's exact test) than non-TSS-affected control subjects (5 of 12). In addition, the average decrease in bactericidal activity in neutrophils obtained during menstruation from recovered TSS patients was 30 ± 9% compared to 7 ± 7% for neutrophils from non-TSS-affected control subjects. The results are consistent with the possibility that transient menstruation-associated decreases in neutrophil bactericidal function may indicate susceptibility and/or contribute to the development of TSS.