Increased Risk of Thrombocytopenia and Death in Patients with Bacteremia Caused by High Alpha Toxin-Producing Methicillin-Resistant Staphylococcus aureus
| Autor: | Emi Minejima, Fatimah Alhurayri, Rachid Douglas-Louis, Juliane Bubeck Wardenburg, Annie Wong-Beringer, Edith Porter |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
business.industry
Health Toxicology and Mutagenesis alpha toxin Staphylococcus aureus bacteremia virulence factors thrombocytopenia Human leukocyte antigen Toxicology medicine.disease medicine.disease_cause Methicillin-resistant Staphylococcus aureus mortality Hemolysis Virulence factor Pathogenesis Staphylococcus aureus Bacteremia Immunology platelets medicine Medicine Platelet business |
| Zdroj: | Toxins Volume 13 Issue 10 Toxins, Vol 13, Iss 726, p 726 (2021) |
| ISSN: | 2072-6651 |
| DOI: | 10.3390/toxins13100726 |
| Popis: | Alpha toxin (Hla) is a major virulence factor of Staphylococcus aureus that targets platelets but clinical data on Hla pathogenesis in bacteremia (SAB) is limited. We examined the link between in vitro Hla activity and outcome. Study isolates obtained from 100 patients with SAB (50 survivors 50 non-survivors) were assessed for in vitro Hla production by Western immunoblotting in a subset of isolates and Hla activity by hemolysis assay in all isolates. Relevant demographics, laboratory and clinical data were extracted from patients’ medical records to correlate Hla activity of the infecting isolates with outcome. Hla production strongly correlated with hemolytic activity (rs = 0.93) in vitro. A trend towards higher hemolytic activity was observed for MRSA compared to MSSA and with high-risk source infection. Significantly higher hemolytic activity was noted for MRSA strains isolated from patients who developed thrombocytopenia (median 52.48 vs. 16.55 HU/mL in normal platelet count, p = 0.012) and from non survivors (median 30.96 vs. 14.87 HU/mL in survivors, p = 0.014) but hemolytic activity of MSSA strains did not differ between patient groups. In vitro Hla activity of MRSA strains obtained from patients with bacteremia is significantly associated with increased risk for thrombocytopenia and death which supports future studies to evaluate feasibility of bedside phenotyping and therapeutic targeting. |
| Databáze: | OpenAIRE |
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