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Persistent Bacteremia Due to Methicillin-Resistant Staphylococcus aureus Infection Is Associated with agr Dysfunction and Low-Level In Vitro Resistance to Thrombin-Induced Platelet Microbicidal Protein

Fowler, Vance G. ; Sakoulas, George ; McIntyre, Lauren M. ; Meka, Venkata G. ; Arbeit, Robert D. ; Cabell, Christopher H. ; Stryjewski, Martin E. ; Eliopoulos, George M. ; Barth Reller, L. ; Ralph Corey, G. ; Jones, Tiffanny ; Lucindo, Natalie ; Yeaman, Michael R. ; Bayer, Arnold S.

The Journal of infectious diseases, 2004-09, Vol.190 (6), p.1140-1149 [Periódico revisado por pares]

Chicago, IL: The University of Chicago Press

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Título:
Persistent Bacteremia Due to Methicillin-Resistant Staphylococcus aureus Infection Is Associated with agr Dysfunction and Low-Level In Vitro Resistance to Thrombin-Induced Platelet Microbicidal Protein
Autor: Fowler, Vance G. ; Sakoulas, George ; McIntyre, Lauren M. ; Meka, Venkata G. ; Arbeit, Robert D. ; Cabell, Christopher H. ; Stryjewski, Martin E. ; Eliopoulos, George M. ; Barth Reller, L. ; Ralph Corey, G. ; Jones, Tiffanny ; Lucindo, Natalie ; Yeaman, Michael R. ; Bayer, Arnold S.
Assuntos: Anti-Bacterial Agents - immunology ; Anti-Bacterial Agents - pharmacology ; Bacteremia - immunology ; Bacteremia - microbiology ; Bacterial diseases ; Bacterial Proteins - genetics ; Bacterial Proteins - physiology ; Bacterial sepsis ; Bacterial Typing Techniques ; Bacteriology ; beta-Thromboglobulin ; Biological and medical sciences ; Chemokines - immunology ; Chemokines - pharmacology ; Deoxyribonucleases, Type II Site-Specific - metabolism ; DNA Fingerprinting ; DNA, Bacterial - analysis ; DNA, Bacterial - isolation & purification ; DNA, Bacterial - metabolism ; Electrophoresis, Gel, Pulsed-Field ; Female ; Fundamental and applied biological sciences. Psychology ; Genotype ; Hemolysin Proteins - metabolism ; Human bacterial diseases ; Humans ; Infectious diseases ; Male ; Medical sciences ; Methicillin Resistance ; Microbiology ; Miscellaneous ; Phenotype ; Polymorphism, Restriction Fragment Length ; Staphylococcal Infections - immunology ; Staphylococcal Infections - microbiology ; Staphylococcus aureus ; Staphylococcus aureus - drug effects ; Staphylococcus aureus - genetics ; Staphylococcus aureus - isolation & purification ; Trans-Activators - genetics ; Trans-Activators - physiology
É parte de: The Journal of infectious diseases, 2004-09, Vol.190 (6), p.1140-1149
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Descrição: Background. The causes of persistent bacteremia (PB) due to methicillin-resistant Staphylococcus aureus (MRSA) are poorly understood. This investigation examined potential associations between PB with key clinical features and several in vitro bacterial genotypic and phenotypic characteristics, in isolates from 1 institution. Methods. Pulsed-field gel electrophoresis (PFGE) relatedness, thrombin-induced platelet microbicidal protein (tPMP)-susceptibility phenotype, accessory gene regulator (agr) genotype and functionality (via δ-lysin production), and autolysis phenotypes were assessed in MRSA isolates from the bloodstream of 21 prospectively identified patients with PB (blood cultures positive after ⩾7 days of therapy) and of 18 patients with resolving bacteremia (RB) (sterile blood cultures within the first 2–4 days of therapy) due to MRSA. Results. The 2 groups had comparable baseline characteristics but differed in their clinical courses (e.g., endocarditis was more frequent in patients with PB than in those with RB [43% vs. 0%, respectively; P = .0016]); isolates from patients with PB exhibited higher rates of (1) survival in vitro after exposure to tPMP (22.4 ± 14.8% vs. 11.6 ± 6.5%, respectively; P = .005); (2) defective δ-lysin production (71.4% vs. 38.9%, respectively; P = .057); (3) non-agr genotype II profile (100% vs. 77.8%, respectively; P = .037); and (4) overrepresentation of a specific PFGE genotype (85.7% vs. 44.4%, respectively; P = .015). Conclusions. Isolates from patients with PB differed from those in patients with RB, in several in vitro characteristics. Further studies will be necessary to define how these factors might affect clinical outcome.
Editor: Chicago, IL: The University of Chicago Press
Idioma: Inglês

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Persistent Bacteremia Due to Methicillin-Resistant Staphylococcus aureus Infection Is Associated with agr Dysfunction and Low-Level In Vitro Resistance to Thrombin-Induced Platelet Microbicidal Protein

Fowler, Vance G. ; Sakoulas, George ; McIntyre, Lauren M. ; Meka, Venkata G. ; Arbeit, Robert D. ; Cabell, Christopher H. ; Stryjewski, Martin E. ; Eliopoulos, George M. ; Barth Reller, L. ; Ralph Corey, G. ; Jones, Tiffanny ; Lucindo, Natalie ; Yeaman, Michael R. ; Bayer, Arnold S.

Chicago, IL: The University of Chicago Press

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