Journal article
Increased mortality with accessory gene regulator (agr) dysfunction in Staphylococcus aureus among bacteremic patients
Antimicrobial agents and chemotherapy, Vol.55(3), pp.1082-1087
03/2011
DOI: 10.1128/AAC.00918-10
PMCID: PMC3067101
PMID: 21173172
Abstract
Accessory gene regulator (agr) dysfunction in Staphylococcus aureus has been associated with a longer duration of bacteremia. We aimed to assess the independent association between agr dysfunction in S. aureus bacteremia and 30-day in-hospital mortality. This retrospective cohort study included all adult inpatients with S. aureus bacteremia admitted between 1 January 2003 and 30 June 2007. Severity of illness prior to culture collection was measured using the modified acute physiology score (APS). agr dysfunction in S. aureus was identified semiquantitatively by using a δ-hemolysin production assay. Cox proportional hazard models were used to measure the association between agr dysfunction and 30-day in-hospital mortality, statistically adjusting for patient and pathogen characteristics. Among 814 patient admissions complicated by S. aureus bacteremia, 181 (22%) patients were infected with S. aureus isolates with agr dysfunction. Overall, 18% of patients with agr dysfunction in S. aureus died, compared to 12% of those with functional agr in S. aureus (P = 0.03). There was a trend toward higher mortality among patients with S. aureus with agr dysfunction (adjusted hazard ratio [HR], 1.34; 95% confidence interval [CI], 0.87 to 2.06). Among patients with the highest APS (scores of >28), agr dysfunction in S. aureus was significantly associated with mortality (adjusted HR, 1.82; 95% CI, 1.03 to 3.21). This is the first study to demonstrate an independent association between agr dysfunction and mortality among severely ill patients. The δ-hemolysin assay examining agr function may be a simple and inexpensive approach to predicting patient outcomes and potentially optimizing antibiotic therapy.
Details
- Title: Subtitle
- Increased mortality with accessory gene regulator (agr) dysfunction in Staphylococcus aureus among bacteremic patients
- Creators
- Marin L Schweizer - Iowa City VAMC, 601 Highway 6 West, Iowa City, IA 52246-2208, USA. marin-schweizer@uiowa.eduJon P FurunoGeorge SakoulasJ Kristie JohnsonAnthony D HarrisMichelle D ShardellJessina C McGregorKerri A ThomEli N Perencevich
- Resource Type
- Journal article
- Publication Details
- Antimicrobial agents and chemotherapy, Vol.55(3), pp.1082-1087
- Publisher
- United States
- DOI
- 10.1128/AAC.00918-10
- PMID
- 21173172
- PMCID
- PMC3067101
- ISSN
- 1098-6596
- eISSN
- 1098-6596
- Grant note
- 1K24AI079040-01A1 / NIAID NIH HHS 1K01AI071015-02 / NIAID NIH HHS K12 HD043489 / NICHD NIH HHS KL2RR024141 / NCRR NIH HHS K23 AI082450 / NIAID NIH HHS HHSN272200700055C / PHS HHS 1R01A160859-01A1 / PHS HHS K01 AI071015 / NIAID NIH HHS HHSN272200700055C / NIAID NIH HHS KL2 RR024141 / NCRR NIH HHS K12HD043489 / NICHD NIH HHS 1K12RR02350-03 / NCRR NIH HHS K24 AI079040 / NIAID NIH HHS
- Language
- English
- Date published
- 03/2011
- Academic Unit
- Epidemiology; Internal Medicine
- Record Identifier
- 9983779290202771
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