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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.

Publication ,  Journal Article
Fowler, VG; Sakoulas, G; McIntyre, LM; Meka, VG; Arbeit, RD; Cabell, CH; Stryjewski, ME; Eliopoulos, GM; Reller, LB; Corey, GR; Jones, T ...
Published in: J Infect Dis
September 15, 2004

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 delta-lysin production), and autolysis phenotypes were assessed in MRSA isolates from the bloodstream of 21 prospectively identified patients with PB (blood cultures positive after > or =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 delta-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.

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Published In

J Infect Dis

DOI

ISSN

0022-1899

Publication Date

September 15, 2004

Volume

190

Issue

6

Start / End Page

1140 / 1149

Location

United States

Related Subject Headings

  • beta-Thromboglobulin
  • Trans-Activators
  • Staphylococcus aureus
  • Staphylococcal Infections
  • Polymorphism, Restriction Fragment Length
  • Phenotype
  • Microbiology
  • Methicillin Resistance
  • Male
  • Humans
 

Citation

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Fowler, V. G., Sakoulas, G., McIntyre, L. M., Meka, V. G., Arbeit, R. D., Cabell, C. H., … Bayer, A. S. (2004). 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. J Infect Dis, 190(6), 1140–1149. https://doi.org/10.1086/423145
Fowler, Vance G., George Sakoulas, Lauren M. McIntyre, Venkata G. Meka, Robert D. Arbeit, Christopher H. Cabell, Martin E. Stryjewski, et al. “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.J Infect Dis 190, no. 6 (September 15, 2004): 1140–49. https://doi.org/10.1086/423145.
Fowler VG, Sakoulas G, McIntyre LM, Meka VG, Arbeit RD, Cabell CH, Stryjewski ME, Eliopoulos GM, Reller LB, Corey GR, Jones T, Lucindo N, Yeaman MR, Bayer AS. 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. J Infect Dis. 2004 Sep 15;190(6):1140–1149.
Journal cover image

Published In

J Infect Dis

DOI

ISSN

0022-1899

Publication Date

September 15, 2004

Volume

190

Issue

6

Start / End Page

1140 / 1149

Location

United States

Related Subject Headings

  • beta-Thromboglobulin
  • Trans-Activators
  • Staphylococcus aureus
  • Staphylococcal Infections
  • Polymorphism, Restriction Fragment Length
  • Phenotype
  • Microbiology
  • Methicillin Resistance
  • Male
  • Humans