Difference in agr dysfunction and reduced vancomycin susceptibility between MRSA bacteremia involving SCCmec types IV/IVa and I-III.

<h4>Background</h4>Dysfunction of agr, with reduced susceptibility or hetero-resistance to vancomycin, is thought to be associated with a worse outcome of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia (MRSAB). However, the difference in agr dysfunction according to the SC...

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Autores principales:	Hee-Chang Jang, Seung-Ji Kang, Su-Mi Choi, Kyung-Hwa Park, Jong-Hee Shin, Hyon E Choy, Sook-In Jung, Hong Bin Kim
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/e9f8ef881f4842a6a25cef79fa0d273f
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spelling	oai:doaj.org-article:e9f8ef881f4842a6a25cef79fa0d273f2021-11-18T08:09:07ZDifference in agr dysfunction and reduced vancomycin susceptibility between MRSA bacteremia involving SCCmec types IV/IVa and I-III.1932-620310.1371/journal.pone.0049136https://doaj.org/article/e9f8ef881f4842a6a25cef79fa0d273f2012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23152862/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Dysfunction of agr, with reduced susceptibility or hetero-resistance to vancomycin, is thought to be associated with a worse outcome of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia (MRSAB). However, the difference in agr dysfunction according to the SCCmec type in MRSA infection is undetermined. We compared the prevalence of agr dysfunction, reduced vancomycin susceptibility and the outcomes of SCCmec IV/IVa and I-III MRSAB.<h4>Methods</h4>The study included 307 cases of MRSAB. SCCmec types were determined by multiplex PCR. The clinical and microbiological features and outcomes of 58 SCCmec IV/IVa MRSAB were compared with those of 249 SCCmec I-III MRSAB.<h4>Results</h4>Compared with SCCmec I-III MRSAB, SCCmec IV/IVa MRSAB was associated with lower rates of agr dysfunction (3% vs. 43%), vancomycin minimum inhibitory concentration (MIC) = 2 µg/mL (3% vs. 15%), and hetero-resistance to vancomycin (0% vs. 8%) (all P<0.05). However, the 30-day and S. aureus-related mortality in patients with SCCmec IV/IVa MRSAB were not different from those in patients with SCCmec I-III MRSAB in multivariate analyses (HR 1.168, 95% CI 0.705-1.938; HR 1.025, 95% CI 0.556-1.889).<h4>Conclusions</h4>SCCmec IV/IVa MRSAB was associated with lower rates of agr dysfunction and hetero-resistance to vancomycin and a lower vancomycin MIC, compared with SCCmec I-III MRSAB. However, the outcomes of SCCmec IV/IVa MRSAB did not differ from those of SCCmec I-III MRSAB.Hee-Chang JangSeung-Ji KangSu-Mi ChoiKyung-Hwa ParkJong-Hee ShinHyon E ChoySook-In JungHong Bin KimPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 11, p e49136 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Hee-Chang Jang Seung-Ji Kang Su-Mi Choi Kyung-Hwa Park Jong-Hee Shin Hyon E Choy Sook-In Jung Hong Bin Kim Difference in agr dysfunction and reduced vancomycin susceptibility between MRSA bacteremia involving SCCmec types IV/IVa and I-III.
description	<h4>Background</h4>Dysfunction of agr, with reduced susceptibility or hetero-resistance to vancomycin, is thought to be associated with a worse outcome of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia (MRSAB). However, the difference in agr dysfunction according to the SCCmec type in MRSA infection is undetermined. We compared the prevalence of agr dysfunction, reduced vancomycin susceptibility and the outcomes of SCCmec IV/IVa and I-III MRSAB.<h4>Methods</h4>The study included 307 cases of MRSAB. SCCmec types were determined by multiplex PCR. The clinical and microbiological features and outcomes of 58 SCCmec IV/IVa MRSAB were compared with those of 249 SCCmec I-III MRSAB.<h4>Results</h4>Compared with SCCmec I-III MRSAB, SCCmec IV/IVa MRSAB was associated with lower rates of agr dysfunction (3% vs. 43%), vancomycin minimum inhibitory concentration (MIC) = 2 µg/mL (3% vs. 15%), and hetero-resistance to vancomycin (0% vs. 8%) (all P<0.05). However, the 30-day and S. aureus-related mortality in patients with SCCmec IV/IVa MRSAB were not different from those in patients with SCCmec I-III MRSAB in multivariate analyses (HR 1.168, 95% CI 0.705-1.938; HR 1.025, 95% CI 0.556-1.889).<h4>Conclusions</h4>SCCmec IV/IVa MRSAB was associated with lower rates of agr dysfunction and hetero-resistance to vancomycin and a lower vancomycin MIC, compared with SCCmec I-III MRSAB. However, the outcomes of SCCmec IV/IVa MRSAB did not differ from those of SCCmec I-III MRSAB.
format	article
author	Hee-Chang Jang Seung-Ji Kang Su-Mi Choi Kyung-Hwa Park Jong-Hee Shin Hyon E Choy Sook-In Jung Hong Bin Kim
author_facet	Hee-Chang Jang Seung-Ji Kang Su-Mi Choi Kyung-Hwa Park Jong-Hee Shin Hyon E Choy Sook-In Jung Hong Bin Kim
author_sort	Hee-Chang Jang
title	Difference in agr dysfunction and reduced vancomycin susceptibility between MRSA bacteremia involving SCCmec types IV/IVa and I-III.
title_short	Difference in agr dysfunction and reduced vancomycin susceptibility between MRSA bacteremia involving SCCmec types IV/IVa and I-III.
title_full	Difference in agr dysfunction and reduced vancomycin susceptibility between MRSA bacteremia involving SCCmec types IV/IVa and I-III.
title_fullStr	Difference in agr dysfunction and reduced vancomycin susceptibility between MRSA bacteremia involving SCCmec types IV/IVa and I-III.
title_full_unstemmed	Difference in agr dysfunction and reduced vancomycin susceptibility between MRSA bacteremia involving SCCmec types IV/IVa and I-III.
title_sort	difference in agr dysfunction and reduced vancomycin susceptibility between mrsa bacteremia involving sccmec types iv/iva and i-iii.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/e9f8ef881f4842a6a25cef79fa0d273f
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Difference in agr dysfunction and reduced vancomycin susceptibility between MRSA bacteremia involving SCCmec types IV/IVa and I-III.

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