Dysfunctional accessory gene regulator (agr) as a prognostic factor in invasive Staphylococcus aureus infection : a systematic review and meta-analysis
Lee, Soon Ok (Pusan National University Hospital, Republic of Korea)
Lee, Shinwon (Pusan National University Hospital, Republic of Korea)
Lee, Jeong Eun (Pusan National University Hospital, Republic of Korea)
Song, Kyoung-Ho (Seoul National University College of Medicine and Seoul National University Bundang Hospital, Republic of Korea)
Kang, Chang Kyung (Seoul National University College of Medicine and Seoul National University Hospital, Republic of Korea)
Wi, Yu Mi (Sungkyunkwan University School of Medicine, Republic of Korea)
San-Juan, Rafael (Instituto de Investigación Sanitaria Hospital 12 de Octubre (i+12))
López-Cortés, Luis E. (Hospital Universitario Virgen Macarena (Sevilla, Andalusia))
Lacoma, Alicia (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Prat i Aymerich, Cristina (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Jang, Hee-Chang (Chonnam National University Medical School. Department of Infectious Diseases, Republic of Korea)
Kim, Eu Suk (Seoul National University College of Medicine and Seoul National University Bundang Hospital, Republic of Korea)
Kim, Hong Bin (Seoul National University College of Medicine and Seoul National University Bundang Hospital, Republic of Korea)
Lee, Sun Hee (Pusan National University Hospital, Republic of Korea)

Date:	2020
Abstract:	The accessory gene regulator (agr) locus of Staphylococcus aureus is a quorum-sensing virulence regulator. Although there are many studies concerning the effect of dysfunctional agr on the outcomes of S. aureus infection, there is no systematic review to date. We systematically searched for clinical studies reporting outcomes of invasive S. aureus infections and the proportion of dysfunctional agr among their causative strains, and we performed a meta-analysis to obtain estimates of the odds of outcomes of invasive S. aureus infection with dysfunctional versus functional agr. Of 289 articles identified by our research strategy, 20 studies were meta-analysed for crude analysis of the impact of dysfunctional agr on outcomes of invasive S. aureus infection. Dysfunctional agr was generally associated with unfavourable outcomes (OR 1. 32, 95% CI 1. 05-1. 66), and the impact of dysfunctional agr on outcome was more prominent in invasive methicillin-resistant S. aureus (MRSA) infections (OR 1. 54, CI 1. 20-1. 97). Nine studies were meta-analysed for the impact of dysfunctional agr on the 30-day mortality of invasive S. aureus infection. Invasive MRSA infection with dysfunctional agr exhibited higher 30-day mortality (OR 1. 40, CI 1. 03-1. 90) than that with functional agr. On the other hand, invasive MSSA infection with dysfunctional agr exhibited lower 30-day mortality (OR 0. 51, CI 0. 27-0. 95). In the post hoc subgroup analysis by the site of MRSA infection, dysfunctional agr was associated with higher 30-day mortality in MRSA pneumonia (OR 2. 48, CI 1. 17-5. 25). The effect of dysfunctional agr on the outcome of invasive S. aureus infection may vary depending on various conditions, such as oxacillin susceptibility and the site of infection. Dysfunctional agr was generally associated with unfavourable clinical outcomes and its effect was prominent in MRSA and pneumonia. Dysfunctional agr may be applicable for outcome prediction in cases of invasive MRSA infection with hardly eradicable foci such as pneumonia.
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Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	Scientific reports, Vol. 10 (november 2020) , ISSN 2045-2322

DOI: 10.1038/s41598-020-77729-0
PMID: 33244173

14 p, 2.1 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
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