ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2017
agr functionality affects clinical outcomes in patients with persistent methicillin-resistant Staphylococcus aureus bacteraemia.
Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 25 citations in OpenAlex.
- Antibiotic heteroresistance in Mycobacterium tuberculosis isolates: a systematic review and meta-analysis.Annals of clinical microbiology and antimicrobials · 2021Pooled it
- Dysfunctional accessory gene regulator (agr) as a prognostic factor in invasive Staphylococcus aureus infection: a systematic review and meta-analysis.Scientific reports · 2020Pooled it
- Population size modulates the transition from gene amplification-mediated heteroresistance to stable resistance.npj antimicrobials and resistance · 2026Article
- Effects of Sub-Inhibitory Rifampicin, Minocycline, and Dalbavancin on Early Biofilm Formation and Transcriptional Responses inMicroorganisms · 2026Article
- Treatment of Methicillin-ResistantMedicines (Basel, Switzerland) · 2026Review
- Colistin heteroresistance, mechanisms, diagnostic methods, and therapeutic options: A review.Germs · 2025Review
- Frequency of cefiderocol heteroresistance among patients treated with cefiderocol for carbapenem-resistantJAC-antimicrobial resistance · 2024Article
- High prevalence of heteroresistance in Staphylococcus aureus is caused by a multitude of mutations in core genes.PLoS biology · 2024Article
- Antibiotic treatment can exacerbate biofilm-associated infection by promoting quorum cheater development.NPJ biofilms and microbiomes · 2023Article
- Persistent Methicillin-ResistantAntibiotics (Basel, Switzerland) · 2023Review
- How does Quorum Sensing of Intestinal Bacteria Affect Our Health and Mental Status?Microorganisms · 2022Review
- Reductive evolution of virulence repertoire to drive the divergence between community- and hospital-associated methicillin-resistantVirulence · 2021Article
- Bacterial virulence plays a crucial role in MRSA sepsis.PLoS pathogens · 2021Article
- Staphylococcus aureus bloodstream infections: pathogenesis and regulatory mechanisms.Current opinion in microbiology · 2020Review
- A Prospective Cohort Study of Durations ofAntimicrobial agents and chemotherapy · 2019Article
- Mechanisms and clinical relevance of bacterial heteroresistance.Nature reviews. Microbiology · 2019Review
- Challenges and Limitations of Anti-quorum Sensing Therapies.Frontiers in microbiology · 2019Article
- Gender affects prognosis of methicillin-resistant Staphylococcus aureus bacteremia differently depending on the severity of underlying disease.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2018Article
- Host-Pathogen-Treatment Triad: Host Factors Matter Most in Methicillin-Resistant Staphylococcus aureus Bacteremia Outcomes.Antimicrobial agents and chemotherapy · 2018Observational
- The Agr Quorum Sensing System Represses Persister Formation through Regulation of Phenol Soluble Modulins inFrontiers in microbiology · 2017Article
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Authors and funding
17 authors at 7 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Methicillin-resistant Staphylococcus aureus bacteremia (MRSAB) often persists despite appropriate antibiotic therapy. It is unclear what microbiological factors contribute to poor clinical outcomes in persistent MRSAB (pMRSAB). We aimed to identify clinical and microbiological risk factors for in-hospital mortality in pMRSAB. We analysed MRSAB cases prospectively collected between 2009 and 2016 at 11 hospitals in Korea, defining cases of pMRSAB as MRSAB lasting ≥5 days despite administration of effective antibiotics. The first blood isolates from the pMRSAB cases were tested for staphylococcal cassette chromosome mec type, staphylococcal protein A type, accessary gene regulator (agr) type, genes for Panton-Valentine leukocidin and phenol-soluble modulin-mec, vancomycin minimum inhibitory concentration, vancomycin heteroresistance, and agr functionality. We also collected clinical information for each case. Of 960 MRSAB cases, 152 pMRSAB were finally eligible. Univariable analysis revealed that in-hospital mortality was significantly associated with Charlson's comorbidity-weighted index (CCWI) score, Pitt bacteremia score, sequential organ failure assessment score, presentation with septic shock, pneumonia, agr dysfunction, and vancomycin heteroresistance. Bone and joint infections were negatively associated with in-hospital mortality. Multivariable analysis revealed the following independent risk factors for in-hospital mortality: CCWI score [adjusted odds ratio (aOR), per one point, 1.25; 95% confidence interval (CI), 1.08-1.44; P = 0.003), Pitt bacteremia score (aOR, per one point, 1.33; 95% CI, 1.09-1.62; P = 0.005), non-eradicated foci of infection (aOR, 3.12; 95% CI, 1.18-8.27; P = 0.022), and agr dysfunction (aOR, 2.48; 95% CI, 1.12-5.47; P = 0.025). agr dysfunction is an independent risk factor for in-hospital mortality in pMRSAB.
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