The discovery of TSST-1 production by TSS-associated strains of S. aureus provided the first major breakthrough in the understanding of the pathogenesis of TSS. Soon, associations between TSST-1 production and other phenotypic and genotypic characteristics of S. aureus became apparent. In the end, appreciation of the microbiology and molecular genetics of TSST-1 and TSS-associated S. aureus has not only enhanced our knowledge of the pathogenesis of TSS, it will undoubtedly bring new concepts and insights into the possible mechanisms and host-parasite interactions in other microbial infections or intoxications as well.