Association between accessory gene regulator polymorphism and mortality among critically III patients receiving vancomycin for nosocomial MRSA bacteremia : a cohort study
Autor(a) principal: | |
---|---|
Data de Publicação: | 2016 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFRGS |
Texto Completo: | http://hdl.handle.net/10183/149725 |
Resumo: | Background. Polymorphism of the accessory gene regulator group II (agr) in methicillin-resistant Staphylococcus aureus (MRSA) is predictive of vancomycin failure therapy. Nevertheless, the impact of group II agr expression on mortality of patients with severe MRSA infections is notwell established. Objective.The goal of our study was to evaluate the association between agr polymorphism and all-cause in-hospital mortality among critically ill patients receiving vancomycin for nosocomial MRSA bacteremia. Methods. All patients with documented bacteremia by MRSA requiring treatment in the ICU between May 2009 and November 2011 were included in the study. Cox proportional hazards regression was performed to evaluate whether agr polymorphism was associated with all-cause in-hospital mortality. Covariates included age, APACHE II score, initial C-reactive protein plasma levels, initial serum creatinine levels, vancomycin minimum inhibitory concentration, vancomycin serum levels, and time to effective antibiotic administration. Results. The prevalence of group I and group II agr expression was 52.4% and 47.6%, respectively. Bacteremia by MRSA group III or group IV agr was not documented in our patients. The mean APACHE II of the study population was 24.3 (standard deviation 8.5). The overall cohort mortality was 66.6% (14 patients). After multivariate analysis, initial plasma C-reactive protein levels ( = 0.01), initial serum creatinine levels ( = 0.008), and expression of group II agr ( = 0.006) were positively associated with all-cause in-hospital mortality. Patients with bacteremia by MRSA with group II agr expression had their risk of death increased by 12.6 times when compared with those with bacteremia by MRSA with group I agr expression. Conclusion. Group II agr polymorphism is associated with an increase in mortality in critically ill patients with bacteremia by MRSA treated with vancomycin. |
id |
UFRGS-2_28beefbbe41905cff118c195a8f48156 |
---|---|
oai_identifier_str |
oai:www.lume.ufrgs.br:10183/149725 |
network_acronym_str |
UFRGS-2 |
network_name_str |
Repositório Institucional da UFRGS |
repository_id_str |
|
spelling |
Cechinel, Angélica BauerMachado, Denise PiresTurra, Eduardo EggersPereira, Dariane CastroSantos, Rodrigo Pires dosRosa, Regis GoulartGoldani, Luciano Zubaran2016-11-19T02:16:35Z20161918-1493http://hdl.handle.net/10183/149725000997303Background. Polymorphism of the accessory gene regulator group II (agr) in methicillin-resistant Staphylococcus aureus (MRSA) is predictive of vancomycin failure therapy. Nevertheless, the impact of group II agr expression on mortality of patients with severe MRSA infections is notwell established. Objective.The goal of our study was to evaluate the association between agr polymorphism and all-cause in-hospital mortality among critically ill patients receiving vancomycin for nosocomial MRSA bacteremia. Methods. All patients with documented bacteremia by MRSA requiring treatment in the ICU between May 2009 and November 2011 were included in the study. Cox proportional hazards regression was performed to evaluate whether agr polymorphism was associated with all-cause in-hospital mortality. Covariates included age, APACHE II score, initial C-reactive protein plasma levels, initial serum creatinine levels, vancomycin minimum inhibitory concentration, vancomycin serum levels, and time to effective antibiotic administration. Results. The prevalence of group I and group II agr expression was 52.4% and 47.6%, respectively. Bacteremia by MRSA group III or group IV agr was not documented in our patients. The mean APACHE II of the study population was 24.3 (standard deviation 8.5). The overall cohort mortality was 66.6% (14 patients). After multivariate analysis, initial plasma C-reactive protein levels ( = 0.01), initial serum creatinine levels ( = 0.008), and expression of group II agr ( = 0.006) were positively associated with all-cause in-hospital mortality. Patients with bacteremia by MRSA with group II agr expression had their risk of death increased by 12.6 times when compared with those with bacteremia by MRSA with group I agr expression. Conclusion. Group II agr polymorphism is associated with an increase in mortality in critically ill patients with bacteremia by MRSA treated with vancomycin.application/pdfengCanadian journal of infectious diseases and medical microbiology. Nasr City. Vol. 2016 (2016), artigo 8163456, 5 p.BacteremiaVancomicinaPolimorfismo genéticoMortalidadeAssociation between accessory gene regulator polymorphism and mortality among critically III patients receiving vancomycin for nosocomial MRSA bacteremia : a cohort studyEstrangeiroinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSORIGINAL000997303.pdf000997303.pdfTexto completo (inglês)application/pdf607637http://www.lume.ufrgs.br/bitstream/10183/149725/1/000997303.pdf8f1b791e7bd587e95855a9e5666600f6MD51TEXT000997303.pdf.txt000997303.pdf.txtExtracted Texttext/plain23269http://www.lume.ufrgs.br/bitstream/10183/149725/2/000997303.pdf.txtfe8b2ccf1e3d2ad334ee21fb8d6489d5MD52THUMBNAIL000997303.pdf.jpg000997303.pdf.jpgGenerated Thumbnailimage/jpeg1846http://www.lume.ufrgs.br/bitstream/10183/149725/3/000997303.pdf.jpgdac6dc3667000b995e1bd7742a25e3c4MD5310183/1497252023-06-15 03:29:20.610335oai:www.lume.ufrgs.br:10183/149725Repositório de PublicaçõesPUBhttps://lume.ufrgs.br/oai/requestopendoar:2023-06-15T06:29:20Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.pt_BR.fl_str_mv |
Association between accessory gene regulator polymorphism and mortality among critically III patients receiving vancomycin for nosocomial MRSA bacteremia : a cohort study |
title |
Association between accessory gene regulator polymorphism and mortality among critically III patients receiving vancomycin for nosocomial MRSA bacteremia : a cohort study |
spellingShingle |
Association between accessory gene regulator polymorphism and mortality among critically III patients receiving vancomycin for nosocomial MRSA bacteremia : a cohort study Cechinel, Angélica Bauer Bacteremia Vancomicina Polimorfismo genético Mortalidade |
title_short |
Association between accessory gene regulator polymorphism and mortality among critically III patients receiving vancomycin for nosocomial MRSA bacteremia : a cohort study |
title_full |
Association between accessory gene regulator polymorphism and mortality among critically III patients receiving vancomycin for nosocomial MRSA bacteremia : a cohort study |
title_fullStr |
Association between accessory gene regulator polymorphism and mortality among critically III patients receiving vancomycin for nosocomial MRSA bacteremia : a cohort study |
title_full_unstemmed |
Association between accessory gene regulator polymorphism and mortality among critically III patients receiving vancomycin for nosocomial MRSA bacteremia : a cohort study |
title_sort |
Association between accessory gene regulator polymorphism and mortality among critically III patients receiving vancomycin for nosocomial MRSA bacteremia : a cohort study |
author |
Cechinel, Angélica Bauer |
author_facet |
Cechinel, Angélica Bauer Machado, Denise Pires Turra, Eduardo Eggers Pereira, Dariane Castro Santos, Rodrigo Pires dos Rosa, Regis Goulart Goldani, Luciano Zubaran |
author_role |
author |
author2 |
Machado, Denise Pires Turra, Eduardo Eggers Pereira, Dariane Castro Santos, Rodrigo Pires dos Rosa, Regis Goulart Goldani, Luciano Zubaran |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Cechinel, Angélica Bauer Machado, Denise Pires Turra, Eduardo Eggers Pereira, Dariane Castro Santos, Rodrigo Pires dos Rosa, Regis Goulart Goldani, Luciano Zubaran |
dc.subject.por.fl_str_mv |
Bacteremia Vancomicina Polimorfismo genético Mortalidade |
topic |
Bacteremia Vancomicina Polimorfismo genético Mortalidade |
description |
Background. Polymorphism of the accessory gene regulator group II (agr) in methicillin-resistant Staphylococcus aureus (MRSA) is predictive of vancomycin failure therapy. Nevertheless, the impact of group II agr expression on mortality of patients with severe MRSA infections is notwell established. Objective.The goal of our study was to evaluate the association between agr polymorphism and all-cause in-hospital mortality among critically ill patients receiving vancomycin for nosocomial MRSA bacteremia. Methods. All patients with documented bacteremia by MRSA requiring treatment in the ICU between May 2009 and November 2011 were included in the study. Cox proportional hazards regression was performed to evaluate whether agr polymorphism was associated with all-cause in-hospital mortality. Covariates included age, APACHE II score, initial C-reactive protein plasma levels, initial serum creatinine levels, vancomycin minimum inhibitory concentration, vancomycin serum levels, and time to effective antibiotic administration. Results. The prevalence of group I and group II agr expression was 52.4% and 47.6%, respectively. Bacteremia by MRSA group III or group IV agr was not documented in our patients. The mean APACHE II of the study population was 24.3 (standard deviation 8.5). The overall cohort mortality was 66.6% (14 patients). After multivariate analysis, initial plasma C-reactive protein levels ( = 0.01), initial serum creatinine levels ( = 0.008), and expression of group II agr ( = 0.006) were positively associated with all-cause in-hospital mortality. Patients with bacteremia by MRSA with group II agr expression had their risk of death increased by 12.6 times when compared with those with bacteremia by MRSA with group I agr expression. Conclusion. Group II agr polymorphism is associated with an increase in mortality in critically ill patients with bacteremia by MRSA treated with vancomycin. |
publishDate |
2016 |
dc.date.accessioned.fl_str_mv |
2016-11-19T02:16:35Z |
dc.date.issued.fl_str_mv |
2016 |
dc.type.driver.fl_str_mv |
Estrangeiro info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10183/149725 |
dc.identifier.issn.pt_BR.fl_str_mv |
1918-1493 |
dc.identifier.nrb.pt_BR.fl_str_mv |
000997303 |
identifier_str_mv |
1918-1493 000997303 |
url |
http://hdl.handle.net/10183/149725 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.ispartof.pt_BR.fl_str_mv |
Canadian journal of infectious diseases and medical microbiology. Nasr City. Vol. 2016 (2016), artigo 8163456, 5 p. |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UFRGS instname:Universidade Federal do Rio Grande do Sul (UFRGS) instacron:UFRGS |
instname_str |
Universidade Federal do Rio Grande do Sul (UFRGS) |
instacron_str |
UFRGS |
institution |
UFRGS |
reponame_str |
Repositório Institucional da UFRGS |
collection |
Repositório Institucional da UFRGS |
bitstream.url.fl_str_mv |
http://www.lume.ufrgs.br/bitstream/10183/149725/1/000997303.pdf http://www.lume.ufrgs.br/bitstream/10183/149725/2/000997303.pdf.txt http://www.lume.ufrgs.br/bitstream/10183/149725/3/000997303.pdf.jpg |
bitstream.checksum.fl_str_mv |
8f1b791e7bd587e95855a9e5666600f6 fe8b2ccf1e3d2ad334ee21fb8d6489d5 dac6dc3667000b995e1bd7742a25e3c4 |
bitstream.checksumAlgorithm.fl_str_mv |
MD5 MD5 MD5 |
repository.name.fl_str_mv |
Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS) |
repository.mail.fl_str_mv |
|
_version_ |
1801224910295531520 |