Yonsei Med J.  2007 Apr;48(2):176-183. 10.3349/ymj.2007.48.2.176.

Accessory Gene Regulator Group Polymorphisms in Methicillin-Resistant Staphylococcus aureus: An Association with Clinical Significance

• Yoon HJ
• Choi JY
• Lee K
• Yong D
• Kim JM
• Song YG

• KMID: 1779518
• DOI: http://doi.org/10.3349/ymj.2007.48.2.176

Abstract

PURPOSE
Virulent gene expression in Staphylococcus aureus is controlled by regulators such as the accessory gene regulator (agr). Strains can be divided into four major agr groups (agr I-IV) on the basis of agrD and agrC polymorphisms. The purpose of this study was to define the proportion of agr I, II, and III polymorphisms and to compare the clinical characteristics between group I and non-group I polymorphisms of methicillin-resistant Staphylococcus aureus (MRSA) strains in a Korean tertiary care teaching hospital. MATERIALS AND METHODS: A total of 158 clinical isolates were evaluated by RFLPs (restriction fragment length polymorphisms). RESULTS: The mean age of the patients was 50.2 +/- 21.9 years old. There were 74 (49.3%), 66 (44.0%), 10 (6.7%), 7 (4.4%), and 1 (0.6%) strains in agr group I, II, III, I + II, and I + III polymorphisms, respectively. Only ear infections were a statistically significant clinical parameter according to univariate (p=0.001) and multivariate analysis (OR, 4.721 (1.273-17.508), p=0.020). CONCLUSION: This study suggests that agr group I is the most prevalent in Korea, and ear infections are correlated with the group I polymorphism, which is a different clinical trend from western countries. It can also be inferred that community-acquired MRSA correlates with agr group I.

Keyword

Staphylococcus aureus; agr polymorphism; otitis

Figure

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  Fig. 1 Representative RFLP analysis with DraI of an amplified portion of the agr locus in MRSA strains on 1.2% agarose gel. M: DNA ladder size marker, A1-5: MRSA strains of agr polymorphism group I, B6-10: group II, C11-12: group II, 13, group I+III, 14, group I+II, D15-18: group III.

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  Fig. 2 The numbers of each agr group from 2002 to 2004.

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