Ans. is 'b' i.e., Mainly endotoxin Impoant facts about virulence factors . Clumping factor is bound coagulase which is responsible for the slide coagulase test. . Coagulase (free coagulase) - Acts along with a coagulase reacting factor (CRF) in plasma. - Eight type of coagulase have been identified, most human strains form coagulase A. - Most constant association of virulence is production of enzyme coagulase and to lesser extent with mannitol fermentation. . Heat stable nuclease (DNAase) is a characteristic feature of staph aureus. . Staphylococcus produces five cytolytic toxins, consisting of four hemolysins (alpha, beta, gamma and delta) and a leucocidin. . a - hemolysin is the most impoant hemolysin. . Beta - hemolysin is a sphingomyelinase. It exhibits a hot-cold phenomenon, the hemolysis being initiated at 37degC, but becoming evident only after chilling. . Leucocidin is also called the Panton-valentine toxin. . Staphylococcal leucocidin and gamma lysin have been grouped as synergohymenotropic toxins. . Toxic shock syndrome toxin (TSST) and enterotoxins are superantigens which are potent activators of T lymphocytes and lead to an excessive and dysregulated immune response with release of cytokines IL-1, IL-2, TNF-a and IFN - y. . Enterotoxin is responsible for food poisoning. . Exfoliative (epidermolytic toxin) - Responsible for staphylococcal scalded skin syndrome (S.S.S.S.). - Severe form of SSSS is known as Ritter disease in newborn and toxic epidermal necrolysis in older patients. Milder forms are pemphigus neonatorum and bullous impetigo. . Staphylococcus does not produce endotoxin. Endotoxin is produced by gram (-) ye organisms, the only gram (+) ye organism secreting endotoxin is listeria.