ArticleAntimicrobial agents and chemotherapy2011
Predictors of agr dysfunction in methicillin-resistant Staphylococcus aureus (MRSA) isolates among patients with MRSA bloodstream infections.
Article in Antimicrobial agents and chemotherapy, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- Global trends and research profile of antibiotic heteroresistance: a bibliometric and visual analysis.Frontiers in microbiology · 2026Pooled it
- Impacts of feeding preweaned calves milk containing drug residues on the functional profile of the fecal microbiota.Scientific reports · 2018Trial
- Treatment of Methicillin-ResistantMedicines (Basel, Switzerland) · 2026Review
- Evidence that staphylococcal superantigens promote within-patient bacterial persistence following post-operative surgical site infection.Infection and immunity · 2025Article
- The role of Staphylococcus aureus quorum sensing in cutaneous and systemic infections.Inflammation and regeneration · 2024Review
- Virulence attributes of successful methicillin-resistantClinical microbiology reviews · 2023Review
- Persistent Methicillin-ResistantAntibiotics (Basel, Switzerland) · 2023Review
- Impact ofMicrobiology spectrum · 2021Article
- Oxidative stress drives the selection of quorum sensing mutants in theProceedings of the National Academy of Sciences of the United States of America · 2019Article
- Accessory gene regulator (agr) dysfunction was unusual in Staphylococcus aureus isolated from Chinese children.BMC microbiology · 2019Article
- Clinical and Molecular Characteristics ofAntimicrobial agents and chemotherapy · 2019Article
- Article
- The Agr Quorum Sensing System Represses Persister Formation through Regulation of Phenol Soluble Modulins inFrontiers in microbiology · 2017Article
- Complete Genome Sequence of the MRSA Isolate HC1335 from ST239 Lineage Displaying a Truncated AgrC Histidine Kinase Receptor.Genome biology and evolution · 2016Article
- Pneumonia Caused by Methicillin-Resistant Staphylococcus aureus: Does Vancomycin Heteroresistance Matter?Antimicrobial agents and chemotherapy · 2016Article
- Capturing the cloud of diversity reveals complexity and heterogeneity of MRSA carriage, infection and transmission.Nature communications · 2015Article
- Genetic and molecular predictors of high vancomycin MIC in Staphylococcus aureus bacteremia isolates.Journal of clinical microbiology · 2014Article
- agr Dysfunction and persistent methicillin-resistant Staphylococcus aureus bacteremia in patients with removed eradicable foci.Infection · 2013Article
- Article
- A novel δ-hemolysis screening method for detecting heteroresistant vancomycin-intermediate Staphylococcus aureus and vancomycin-intermediate S. aureus.Journal of clinical microbiology · 2012Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
Despite emerging evidence that dysfunction in the accessory gene regulator (agr) locus is associated with deleterious outcomes among patients treated with vancomycin for methicillin-resistant Staphylococcus aureus (MRSA) infections, factors predictive of agr dysfunction have not been evaluated. This study describes the epidemiology of agr dysfunction, identifies predictors of agr dysfunction in MRSA isolates among those with MRSA bloodstream infections, and describes the relationship between agr dysfunction and other microbiologic phenotypes. A cross-sectional study of patients with MRSA bloodstream infections at two institutions in upstate New York was performed. Clinical data on demographics, comorbidities, disease severity, hospitalization history, and antibiotic history were collected. Microbiologic phenotypes, including agr dysfunction, MIC values by broth microdilution (BMD) and Etest, and vancomycin heteroresistance (hVISA) were tested. Multivariable analyses were performed to identify factors predictive of agr dysfunction. Among 200 patients with an MRSA bloodstream infection, the proportion of strains with agr dysfunction was 31.5%. The distribution of MICs determined by both BMD and Etest were equivalent across agr groups, and there was no association between agr dysfunction and the presence of hVISA. Severity of illness, comorbidities, and hospitalization history were comparable between agr groups. In the multivariate analysis, prior antibiotic exposure was the only factor of variables studied found to be predictive of agr dysfunction. This relationship was predominantly driven by prior beta-lactam and fluoroquinolone administration in the bivariate analysis. Identifying these institution-specific risk factors can be used to develop a process to assess the risk of agr dysfunction and guide empirical antibiotic therapy decisions.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.