This Article Full Text Full Text (PDF) Supplemental material Other Versions of this Article: JCM.01822-07v1 46/2/678    most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints and Permissions Copyright Information Books from ASM Press MicrobeWorld Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Campbell, S. J. Articles by Fowler, V. G. Search for Related Content PubMed PubMed Citation Articles by Campbell, S. J. Articles by Fowler, V. G., Jr.

 Previous Article  |  Next Article 

Journal of Clinical Microbiology, February 2008, p. 678-684, Vol. 46, No. 2
0095-1137/08/$08.00+0     doi:10.1128/JCM.01822-07
Copyright © 2008, American Society for Microbiology. All Rights Reserved.

Genotypic Characteristics of Staphylococcus aureus Isolates from a Multinational Trial of Complicated Skin and Skin Structure Infections ^,

Department of Medicine, Duke University Medical Center,¹ Duke Clinical Research Institute, Durham, North Carolina,² Theravance, South San Francisco, California,³ Department of Internal Medicine, Gyeongsang National University School of Medicine, Gyeongsang, South Korea⁴

Received 13 September 2007/ Returned for modification 24 October 2007/ Accepted 20 November 2007

The impact of bacterial genetic characteristics on the outcome of patients with Staphylococcus aureus infections is uncertain. This investigation evaluated potential associations between bacterial genotype and clinical outcome using isolates collected as part of an international phase 2 clinical trial (FAST II) evaluating telavancin for the treatment of complicated skin and skin structure infections (cSSSI). Ninety S. aureus isolates from microbiologically evaluable patients with cSSSI enrolled in the FAST II trial from 11 sites in the United States (56 isolates, or 62%) and 7 sites in South Africa (34 isolates, or 38%) were examined for staphylococcal cassette chromosome mec, agr, and the presence of 31 virulence genes and subjected to pulsed-field gel electrophoresis (PFGE). South African methicillin-susceptible S. aureus (MSSA) isolates were more likely to carry certain virulence genes, including sdrD (P = 0.01), sea (P < 0.01), and pvl (P = 0.01). All 44 (49%) methicillin-resistant S. aureus (MRSA) isolates were from the United States; 37 (84%) were strain USA 300 by PFGE. In the United States, MRSA isolates were more likely than MSSA isolates to carry genes for sdrC (P = 0.03), map/eap (P = 0.05), fnbB (P = 0.11), tst (P = 0.02), sea (P = 0.04), sed (P = 0.04), seg (P = 0.11), sej (P = 0.11), agr (P = 0.09), V8 (P = 0.06), sdrD, sdrE, eta, etb, and see (P < 0.01 for all). MRSA isolates were more often clonal than MSSA isolates by PFGE. Isolates from patients who were cured were significantly more likely to contain the pvl gene than isolates from patients that failed or had indeterminate outcomes (79/84 [94%] versus 3/6 [50%]; P = 0.01). S. aureus strains from different geographic regions have different distributions of virulence genes.

Published ahead of print on 12 December 2007.

Supplemental material for this article may be found at http://jcm.asm.org/.

This article has been cited by other articles:

• Goering, R. V., Shawar, R. M., Scangarella, N. E., O'Hara, F. P., Amrine-Madsen, H., West, J. M., Dalessandro, M., Becker, J. A., Walsh, S. L., Miller, L. A., van Horn, S. F., Thomas, E. S., Twynholm, M. E. (2008). Molecular Epidemiology of Methicillin-Resistant and Methicillin-Susceptible Staphylococcus aureus Isolates from Global Clinical Trials. J. Clin. Microbiol. 46: 2842-2847 [Abstract] [Full Text]