Extracellular protein toxins contribute to the pathogenesis of a wide variety of Staphylococcus aureus infections. The present study investigated the effects that cell‐wall active antibiotics and protein‐synthesis inhibitors have on transcription and translation of genes for Panton‐Valentine leukocidin, alpha‐hemolysin, and toxic‐shock syndrome toxin 1, in both methicillin‐sensitive and methicillin‐resistant S. aureus. Subinhibitory concentrations of nafcillin induced and prolonged mRNA for Panton‐Valentine leukocidin, alpha‐toxin, and toxic‐shock syndrome toxin 1 and increased toxin production. In contrast, clindamycin and linezolid markedly suppressed translation, but not transcription, of toxin genes. These results suggest (1) that protein‐synthesis inhibition is an important consideration in the selection of antimicrobial agents to treat serious infections caused by toxin‐producing gram‐positive pathogens and (2) that, by inducing and enhancing toxin production, inadvertent use of beta‐lactam antibiotics to treat methicillin‐resistant S. aureus infections may contribute to worse outcomes.
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