© Toxins Staphylococcus aureus produces a number of named cytolytic toxins (a, B, 8, y), of which a-toxin is the most important. a-Toxin, is a protein secreted by almost all strains of $ aureus, but not by coagulase-negative staphylococci. It is a pore-forming cytotoxin (see Figure 22-6) that lyses the cytoplasmic membranes by direct insertion into the lipid bilayer to form transmembrane pores (Figure 24-2). The resultant egress of vital molecules leads to cell death. This action is similar to streptolysin O, complement, and the effector pro- teins of cytotoxic T-lymphocytes. a-Toxin is not active against neutrophils but does lyse a wide variety of other cells including keratinocytes. Another pore-forming toxin is active against neutrophils and thus long ago named Panton-Valentine leukocidin (PVL). PVL is also active against platelets. It causes tissue necrosis but until recently was found in only a small portion of clinical isolates (less than 10%). wA+ 808 89GB