Accessory gene regulator group II polymorphism in methicillin-resistant Staphylococcus aureus is predictive of failure of vancomycin therapy
Accessory gene regulator group II polymorphism in methicillin-resistant Staphylococcus aureus is predictive of failure of vancomycin therapy
复制标题
DOI：
10.1086/421092
复制
发表时间：
2004-06-15
影响因子：
11.8
通讯作者：
Moellering, RC
中科院分区：
文献类型：
--
作者：
Moise-Broder, PA;Sakoulas, G;Moellering, RC
我们研究了耐甲氧西林金黄色葡萄球菌 (MRSA) 分离株，以确定辅助基因调节基因 (agr) 位点的 II 组多态性是否与万古霉素的临床疗效有任何关系。对来自 87 名接受万古霉素治疗的患者的 122 株 MRSA 分离株进行了评估。 87 名患者中有 45 名对万古霉素没有临床或细菌学反应。在 36 名具有 agr II 型多态性的临床可评估患者中，31 名感染者对万古霉素没有反应，而只有 5 名感染者对万古霉素成功反应。鉴于我们之前的发现，即美国和日本的糖肽中度耐药金黄色葡萄球菌（GISA）和异源GISA临床分离株富含agr II组多态性，这一发现很有意义，这表明一些带有该遗传标记的金黄色葡萄球菌克隆在万古霉素选择压力下可能具有内在的生存优势。
We studied methicillin-resistant Staphylococcus aureus (MRSA) isolates to determine if the group II polymorphism at the accessory gene regulator (agr) locus demonstrated any relationship with the clinical efficacy of vancomycin. One hundred twenty-two MRSA isolates from 87 patients treated with vancomycin were evaluated. Forty-five of 87 patients had no clinical or bacteriological response to vancomycin. Among the 36 clinically evaluable patients with the agr group II polymorphism, 31 had an infection that failed to respond to vancomycin, whereas only 5 had an infection that responded successfully to vancomycin. This finding is of interest in light of our previous findings that glycopeptide-intermediately resistant S. aureus (GISA) and hetero-GISA clinical isolates in the United States and Japan are enriched for the agr group II polymorphism, and it suggests a possible intrinsic survival advantage of some S. aureus clones with this genetic marker under vancomycin selective pressure.