Vaginal Tampon Colonization by Staphylococcus aureus in Healthy Women [1]


Tampons recovered from a cohort of 737 healthy women (median age, 32 years) were analysed for the presence of Staphylococcus aureus

A total of 198 tampons (27%) were colonized by S. aureus, 28 (4%) by a strain producing toxic shock syndrome toxin 1 (TSST-1).

S. aureus was detected more frequently in tampons that did not require an applicator for their insertion [32% versus 24%] and in women who used an intrauterine device for contraception [34% versus 27%].



Menstrual toxic shock syndrome (MTSS) is an uncommon severe acute disease that occurs in healthy menstruating women colonized by TSST-1-producing S. aureus who use intravaginal protection, such as tampons and menstrual cups.

The catamenial product collected by the protection serves as a growth medium for S. aureus and allows TSST-1 production. Previous studies evaluated the prevalence of genital colonization by S. aureus by vaginal swabbing, but they did not examine tampon colonization. This study demonstrated a high prevalence of tampon colonization by S. aureus and the presence of the CC30 TSST-1 S. aureus clone responsible for MTSS in tampons from healthy women.

The results support the vaginal carriage of this lineage in healthy women.

In addition, the higher prevalence of S. aureus within tampons that do not require an applicator indicates a crucial role for handwashing before tampon handling to decrease the risk of tampon contamination.


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