Dysfunctional accessory gene regulator (agr) as a prognostic factor in invasive Staphylococcus aureus infection: a systematic review and meta-analysis
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 clinic...
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| creator | Lee, Soon Ok Lee, Shinwon Lee, Jeong Eun Song, Kyoung-Ho Kang, Chang Kyung Wi, Yu Mi San-Juan, Rafael López-Cortés, Luis E. Lacoma, Alicia Prat, Cristina Jang, Hee-Chang Kim, Eu Suk Kim, Hong Bin Lee, Sun Hee |
| description | 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. |
| doi_str_mv | 10.1038/s41598-020-77729-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7691521</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2465438272</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-3ba1c3d9585ef9abd37220fa1dec84df722974823f56c6d129604aefab95b3fe3</originalsourceid><addsrcrecordid>eNp9kctu1TAQhiMEolXpC7BAltiURcC3xDELpKpcpUosgLU1ccapqxz7YCcH5UV4Xnx6SikssCyNrfnmnxn9VfWU0ZeMiu5VlqzRXU05rZVSXNf0QXXMqWxqLjh_eO99VJ3mfE3LabiWTD-ujoTgUjIljqufb9fslmBnHwNMBKzFnGNayYgBScJxmWCOiZzBmF4QyATINsUxxDx7SxzYfdKHcneQ_Q7Jlxm2V-sUbbR2KfiSsAQfHN70eF0E8ppn3MBeIOHO4w8CYSAbnKGGMsSafX5SPXIwZTy9jSfVt_fvvl58rC8_f_h0cX5ZW6nkXIsemBWDbroGnYZ-EIpz6oANaDs5uPLTSnZcuKa17cC4bqkEdNDrphcOxUn15qC7XfoNDhbDnGAy2-Q3kFYTwZu_M8FfmTHujGo1azgrAme3Ail-XzDPZuOzxWmCgHHJhsu2kaLjihf0-T_odVxSWXhPKcFb1XJZKH6gbIo5J3R3wzBq9s6bg_OmOG9unDe0FD27v8ZdyW-fCyAOQC6pMGL60_s_sr8AfuK9wg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2473267624</pqid></control><display><type>article</type><title>Dysfunctional accessory gene regulator (agr) as a prognostic factor in invasive Staphylococcus aureus infection: a systematic review and meta-analysis</title><source>MEDLINE</source><source>Nature Free</source><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><source>Free Full-Text Journals in Chemistry</source><source>Springer Nature OA Free Journals</source><creator>Lee, Soon Ok ; Lee, Shinwon ; Lee, Jeong Eun ; Song, Kyoung-Ho ; Kang, Chang Kyung ; Wi, Yu Mi ; San-Juan, Rafael ; López-Cortés, Luis E. ; Lacoma, Alicia ; Prat, Cristina ; Jang, Hee-Chang ; Kim, Eu Suk ; Kim, Hong Bin ; Lee, Sun Hee</creator><creatorcontrib>Lee, Soon Ok ; Lee, Shinwon ; Lee, Jeong Eun ; Song, Kyoung-Ho ; Kang, Chang Kyung ; Wi, Yu Mi ; San-Juan, Rafael ; López-Cortés, Luis E. ; Lacoma, Alicia ; Prat, Cristina ; Jang, Hee-Chang ; Kim, Eu Suk ; Kim, Hong Bin ; Lee, Sun Hee</creatorcontrib><description>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.</description><identifier>ISSN: 2045-2322</identifier><identifier>EISSN: 2045-2322</identifier><identifier>DOI: 10.1038/s41598-020-77729-0</identifier><identifier>PMID: 33244173</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>631/250/255 ; 631/250/255/1318 ; Bacterial Proteins - genetics ; Drug resistance ; Humanities and Social Sciences ; Humans ; Meta-analysis ; Methicillin ; Methicillin-Resistant Staphylococcus aureus - genetics ; Mortality ; multidisciplinary ; Oxacillin ; Pneumonia ; Prognosis ; Science ; Science (multidisciplinary) ; Staphylococcal Infections - microbiology ; Staphylococcal Infections - pathology ; Staphylococcus aureus ; Staphylococcus infections ; Systematic review ; Virulence ; Virulence Factors - genetics</subject><ispartof>Scientific reports, 2020-11, Vol.10 (1), p.20697-20697, Article 20697</ispartof><rights>The Author(s) 2020</rights><rights>The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-3ba1c3d9585ef9abd37220fa1dec84df722974823f56c6d129604aefab95b3fe3</citedby><cites>FETCH-LOGICAL-c474t-3ba1c3d9585ef9abd37220fa1dec84df722974823f56c6d129604aefab95b3fe3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7691521/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7691521/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27903,27904,41099,42168,51554,53769,53771</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33244173$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Soon Ok</creatorcontrib><creatorcontrib>Lee, Shinwon</creatorcontrib><creatorcontrib>Lee, Jeong Eun</creatorcontrib><creatorcontrib>Song, Kyoung-Ho</creatorcontrib><creatorcontrib>Kang, Chang Kyung</creatorcontrib><creatorcontrib>Wi, Yu Mi</creatorcontrib><creatorcontrib>San-Juan, Rafael</creatorcontrib><creatorcontrib>López-Cortés, Luis E.</creatorcontrib><creatorcontrib>Lacoma, Alicia</creatorcontrib><creatorcontrib>Prat, Cristina</creatorcontrib><creatorcontrib>Jang, Hee-Chang</creatorcontrib><creatorcontrib>Kim, Eu Suk</creatorcontrib><creatorcontrib>Kim, Hong Bin</creatorcontrib><creatorcontrib>Lee, Sun Hee</creatorcontrib><title>Dysfunctional accessory gene regulator (agr) as a prognostic factor in invasive Staphylococcus aureus infection: a systematic review and meta-analysis</title><title>Scientific reports</title><addtitle>Sci Rep</addtitle><addtitle>Sci Rep</addtitle><description>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.</description><subject>631/250/255</subject><subject>631/250/255/1318</subject><subject>Bacterial Proteins - genetics</subject><subject>Drug resistance</subject><subject>Humanities and Social Sciences</subject><subject>Humans</subject><subject>Meta-analysis</subject><subject>Methicillin</subject><subject>Methicillin-Resistant Staphylococcus aureus - genetics</subject><subject>Mortality</subject><subject>multidisciplinary</subject><subject>Oxacillin</subject><subject>Pneumonia</subject><subject>Prognosis</subject><subject>Science</subject><subject>Science (multidisciplinary)</subject><subject>Staphylococcal Infections - microbiology</subject><subject>Staphylococcal Infections - pathology</subject><subject>Staphylococcus aureus</subject><subject>Staphylococcus infections</subject><subject>Systematic review</subject><subject>Virulence</subject><subject>Virulence Factors - genetics</subject><issn>2045-2322</issn><issn>2045-2322</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kctu1TAQhiMEolXpC7BAltiURcC3xDELpKpcpUosgLU1ccapqxz7YCcH5UV4Xnx6SikssCyNrfnmnxn9VfWU0ZeMiu5VlqzRXU05rZVSXNf0QXXMqWxqLjh_eO99VJ3mfE3LabiWTD-ujoTgUjIljqufb9fslmBnHwNMBKzFnGNayYgBScJxmWCOiZzBmF4QyATINsUxxDx7SxzYfdKHcneQ_Q7Jlxm2V-sUbbR2KfiSsAQfHN70eF0E8ppn3MBeIOHO4w8CYSAbnKGGMsSafX5SPXIwZTy9jSfVt_fvvl58rC8_f_h0cX5ZW6nkXIsemBWDbroGnYZ-EIpz6oANaDs5uPLTSnZcuKa17cC4bqkEdNDrphcOxUn15qC7XfoNDhbDnGAy2-Q3kFYTwZu_M8FfmTHujGo1azgrAme3Ail-XzDPZuOzxWmCgHHJhsu2kaLjihf0-T_odVxSWXhPKcFb1XJZKH6gbIo5J3R3wzBq9s6bg_OmOG9unDe0FD27v8ZdyW-fCyAOQC6pMGL60_s_sr8AfuK9wg</recordid><startdate>20201126</startdate><enddate>20201126</enddate><creator>Lee, Soon Ok</creator><creator>Lee, Shinwon</creator><creator>Lee, Jeong Eun</creator><creator>Song, Kyoung-Ho</creator><creator>Kang, Chang Kyung</creator><creator>Wi, Yu Mi</creator><creator>San-Juan, Rafael</creator><creator>López-Cortés, Luis E.</creator><creator>Lacoma, Alicia</creator><creator>Prat, Cristina</creator><creator>Jang, Hee-Chang</creator><creator>Kim, Eu Suk</creator><creator>Kim, Hong Bin</creator><creator>Lee, Sun Hee</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88A</scope><scope>88E</scope><scope>88I</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20201126</creationdate><title>Dysfunctional accessory gene regulator (agr) as a prognostic factor in invasive Staphylococcus aureus infection: a systematic review and meta-analysis</title><author>Lee, Soon Ok ; Lee, Shinwon ; Lee, Jeong Eun ; Song, Kyoung-Ho ; Kang, Chang Kyung ; Wi, Yu Mi ; San-Juan, Rafael ; López-Cortés, Luis E. ; Lacoma, Alicia ; Prat, Cristina ; Jang, Hee-Chang ; Kim, Eu Suk ; Kim, Hong Bin ; Lee, Sun Hee</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-3ba1c3d9585ef9abd37220fa1dec84df722974823f56c6d129604aefab95b3fe3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>631/250/255</topic><topic>631/250/255/1318</topic><topic>Bacterial Proteins - genetics</topic><topic>Drug resistance</topic><topic>Humanities and Social Sciences</topic><topic>Humans</topic><topic>Meta-analysis</topic><topic>Methicillin</topic><topic>Methicillin-Resistant Staphylococcus aureus - genetics</topic><topic>Mortality</topic><topic>multidisciplinary</topic><topic>Oxacillin</topic><topic>Pneumonia</topic><topic>Prognosis</topic><topic>Science</topic><topic>Science (multidisciplinary)</topic><topic>Staphylococcal Infections - microbiology</topic><topic>Staphylococcal Infections - pathology</topic><topic>Staphylococcus aureus</topic><topic>Staphylococcus infections</topic><topic>Systematic review</topic><topic>Virulence</topic><topic>Virulence Factors - genetics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Soon Ok</creatorcontrib><creatorcontrib>Lee, Shinwon</creatorcontrib><creatorcontrib>Lee, Jeong Eun</creatorcontrib><creatorcontrib>Song, Kyoung-Ho</creatorcontrib><creatorcontrib>Kang, Chang Kyung</creatorcontrib><creatorcontrib>Wi, Yu Mi</creatorcontrib><creatorcontrib>San-Juan, Rafael</creatorcontrib><creatorcontrib>López-Cortés, Luis E.</creatorcontrib><creatorcontrib>Lacoma, Alicia</creatorcontrib><creatorcontrib>Prat, Cristina</creatorcontrib><creatorcontrib>Jang, Hee-Chang</creatorcontrib><creatorcontrib>Kim, Eu Suk</creatorcontrib><creatorcontrib>Kim, Hong Bin</creatorcontrib><creatorcontrib>Lee, Sun Hee</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Biology Database (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Scientific reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Soon Ok</au><au>Lee, Shinwon</au><au>Lee, Jeong Eun</au><au>Song, Kyoung-Ho</au><au>Kang, Chang Kyung</au><au>Wi, Yu Mi</au><au>San-Juan, Rafael</au><au>López-Cortés, Luis E.</au><au>Lacoma, Alicia</au><au>Prat, Cristina</au><au>Jang, Hee-Chang</au><au>Kim, Eu Suk</au><au>Kim, Hong Bin</au><au>Lee, Sun Hee</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Dysfunctional accessory gene regulator (agr) as a prognostic factor in invasive Staphylococcus aureus infection: a systematic review and meta-analysis</atitle><jtitle>Scientific reports</jtitle><stitle>Sci Rep</stitle><addtitle>Sci Rep</addtitle><date>2020-11-26</date><risdate>2020</risdate><volume>10</volume><issue>1</issue><spage>20697</spage><epage>20697</epage><pages>20697-20697</pages><artnum>20697</artnum><issn>2045-2322</issn><eissn>2045-2322</eissn><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.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>33244173</pmid><doi>10.1038/s41598-020-77729-0</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2045-2322 |
| ispartof | Scientific reports, 2020-11, Vol.10 (1), p.20697-20697, Article 20697 |
| issn | 2045-2322 2045-2322 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7691521 |
| source | MEDLINE; Nature Free; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Alma/SFX Local Collection; Free Full-Text Journals in Chemistry; Springer Nature OA Free Journals |
| subjects | 631/250/255 631/250/255/1318 Bacterial Proteins - genetics Drug resistance Humanities and Social Sciences Humans Meta-analysis Methicillin Methicillin-Resistant Staphylococcus aureus - genetics Mortality multidisciplinary Oxacillin Pneumonia Prognosis Science Science (multidisciplinary) Staphylococcal Infections - microbiology Staphylococcal Infections - pathology Staphylococcus aureus Staphylococcus infections Systematic review Virulence Virulence Factors - genetics |
| title | Dysfunctional accessory gene regulator (agr) as a prognostic factor in invasive Staphylococcus aureus infection: a systematic review and meta-analysis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-27T05%3A57%3A29IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Dysfunctional%20accessory%20gene%20regulator%20(agr)%20as%20a%20prognostic%20factor%20in%20invasive%20Staphylococcus%20aureus%20infection:%20a%20systematic%20review%20and%20meta-analysis&rft.jtitle=Scientific%20reports&rft.au=Lee,%20Soon%20Ok&rft.date=2020-11-26&rft.volume=10&rft.issue=1&rft.spage=20697&rft.epage=20697&rft.pages=20697-20697&rft.artnum=20697&rft.issn=2045-2322&rft.eissn=2045-2322&rft_id=info:doi/10.1038/s41598-020-77729-0&rft_dat=%3Cproquest_pubme%3E2465438272%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2473267624&rft_id=info:pmid/33244173&rfr_iscdi=true |