Note A toroid model for in vitro investigations of toxic shock syndrome toxin-1 production J.A. Flood a, * , T.J. Tripp b , C.C. Davis c , D.R. Hill c , P.M. Schlievert b a Central Product Safety Division, Procter & Gamble Company, 11810 East Miami River Road, Colerain Township, OH 45252, USA b Department of Microbiology, University of Minnesota Medical School, Minneapolis, MN 55455, USA c Feminine Care Division, Procter & Gamble Company, Center Hill Road, Cincinnati, OH 45224, USA Received 22 December 2003; accepted 8 January 2004 Abstract Human behaviours and consumer products may affect vaginal microbial ecology, thereby influencing women’s health. Relevant experimentation systems are needed to understand such possible links. Here, we describe the development of a practical semi-solid in vitro model to assess the effects of interactions between vaginal environment and the presence of tampons, on bacterial communities, including the production of toxic shock syndrome toxin-1 (TSST-1) by Staphylococcus aureus. D 2004 Elsevier B.V. All rights reserved. Keywords: Bacteria; Model; Tampon; Toroid; Toxic shock syndrome toxin-1; Vagina The human vagina supports various microbial species, whose interactions with each other and with the human host can either promote or inhibit health problems in women (e.g., sexually transmitted dis- eases [STDs]; menstrual toxic shock syndrome [mTSS]; bacterial vaginosis [BV]; candidiasis; and childbirth complications). Understanding interactions within this microbial ecosystem and the effects of human behaviours and consumer products on these consortia may aid in improving women’s health. Staphylococcus aureus is a versatile human path- ogen. Major virulence factors of this organism include exotoxins such as staphylococcal enterotoxin (SE) serotypes A to Q (excluding F) (McCormick et al., 2001), and toxic shock syndrome toxin-1 (TSST-1). These superantigens hyperstimulate the immune sys- tem through their ability to induce massive cytokine release (Kotzin et al., 1993; McCormick et al., 2001). Non-menstrual toxic shock syndrome (nmTSS) can occur in both males and females, developing in association with focal infections or surgery, and is correlated predominately with the superantigens TSST-1, SEB and SEC (Bohach et al., 1990; Dinges et al., 1990). A single staphylococcal exotoxin, TSST- 1, is linked to virtually all menstrual cases of TSS (McCormick et al., 2001). mTSS is a rare, recognis- able and treatable disease that has been associated with tampon use in women within the f 5–25% of adults who lack neutralising anti-TSST-1 antibodies 0167-7012/$ - see front matter D 2004 Elsevier B.V. All rights reserved. doi:10.1016/j.mimet.2004.01.005 * Corresponding author. Tel.: +1-513-627-1596; fax: +1-513- 627-1233. E-mail address: Flood.JA@pg.com (J.A. Flood). www.elsevier.com/locate/jmicmeth Journal of Microbiological Methods 57 (2004) 283 – 288