Table 1.
Studies in which the association between agr dysfunction and treatment outcomes of invasive Staphylococcus aureus infections was able to be evaluated.
| Study and publication year | Location | Study period | Isolate No., MR/MS (%) | No. of centres | Inclusion/study setting | No. (%) of IE | Main therapeutic agents (%) | Proportion of agr dysfunction according to outcomes (no. of agr dysfunction/total no.) | Proportion of high VM MIC (%) |
|---|---|---|---|---|---|---|---|---|---|
| Studies that collected cases and isolates consecutively | |||||||||
| Schweizer (2011)29 | USA | 2003–2007 | 814, MR(60)/MS(40) | 1 | SAB, adult/retrospective | 138 (17) | VM (86) | Death (30 day) 33/109 vs. Survival 149/705 | MIC ≥ 1.5 (76.2) |
| Chong (2013)35 | Korea | 2008–2010 | 159, MR (100) | 1 | MRSAB excluding intermediate duration, Adult/Prospective | NR | VM (92.8), TP (3.6), LZ (3.6) | PB 44/65 vs. NPB 63/94d | NR |
| Jang (2013)24 | Korea | 2005–2008 | 307, MR (100) | 2 | MRSAB (≥ 16 years)/retrospective | 2 (0.7) | GP (75.2) | Death (30 day) 36/98 vs. Survival 72/209 | MIC = 2 (12.7), hVISA (6.2) |
| Wi (2015)27 | Korea | 2011–2012 | 146, MS (100) | 9 | MSSAB/prospective | 19 (13) | fBLT (69.2), BLT + GP (21.9), GP (2.1) | Death (30 day) 2/33 vs. Survival 17/113 | NR |
| Kang (2015)31 | Korea | 2009–2013 | 171, MR (100) | 1 | MRSAB (≥ 15 years)/prospective | NR | fVM (99.4), LZ (0.6) | Death (SAB-attributable) 34/44 vs. Survival 72/127d | NR |
| López-Cortés (2015)36 | Spain | 2008–2011 | 135, MS (100) | 1 | MSSAB (≥ 18 years)/prospective | NR | fBTL (87.6), GP (6.2), others (6.2) |
1) Death (30 day) 23/37 vs. Survival 47/98 2) PB 14/26 vs. NPB 48/99 |
MIC ≥ 1.5 (21.5) |
| Sullivan (2017)37 | USA | 2010–2012 | 252, MS (100) | 1 | MSSAB (≥ 18 years)/Retrospective | NR | gVM (66.5), BLT (27.3), others (6.2) | Death (30 day) 2/45 vs. Survival 18/207 | MIC ≥ 2 (33.3) |
| Studies that collected cases and isolates by specific conditions other than the site of infection | |||||||||
| Fowler (2004)7 | USA | 1995–2000 | 39, MR (100) | 1 | SAB (≥ 18 years), All PB (n = 21) and randomly selected NPB (n = 18) | 9 (23.1) | VM (97.4), [adjunctive AG (33.3), RF (10.3)] | PB 15/21 vs. NPB 7/18 | NR |
| Moise (2007)38,a | USA | 1998–2002 | 34, MR (100) | 6 | Randomly selected agr II MRSAB and matched non-agr-II MRSAB | 0 (0) | VMb | PB 14/16 vs. NPB 11/18 | NR |
| McCalla (2008)39,b | USA | 2002–2005 | 89, MR (100) | M | MRSAB from clinical trial comparing DM (n = 45) vs. standard treatment (n = 44)/Post hoc analysis40 | NR | DM (50.6), VM + AG (49.4) | Failure 16/55 vs. Cure 9/34 | NR |
| Walraven (2011)41 | USA | 2002–2009 | 139, MR (100) | 1 | MRSAB (≥ 18 years) and received VM/retrospective | 29 (20.9) | VM (100) | Failure 13/67 vs. Cure 13/72 | MIC ≥ 1.5 (92.1) |
| Casapao (2013)42 | USA | 2004–2012 | 122, MR (100) | 5 | hVISAB (n = 61) and matched VSSAB (n = 61)/retrospective | 48 (39.3) | VM (100) | Failure 15/70 vs. Success 7/52 | hVISA (50) |
| Hu (2015)43 | Taiwan | 2009–2010 | 48, MR (100) | 1 | MRSAB & treated in ICUs (≥ 18 years)/retrospective | NR | NR | Death (in hospital) 12/35 vs. Survival 1/13 | hVISA (27.1) |
| Kang (2017)32 | Korea | 2009–2016 | 152, MR (100) | 11 | Persistent SAB among 960 MRSAB (≥ 15 years)/prospective | 11 (7.2) | gVM (90.1), [adjunctive RF (10.5)] | Death (in hospital) 34/50 vs. Survival 50/102d | MIC ≥ 1.5 (56.6), hVISA (7.2) |
| Yang (2018)44 | Taiwan | 2009–2012 | 147, MR (100) | 1 | High VM MIC(= 2 mg/L) MRSAB/Retrospective | NR | DM (37.4), GM (54.4), Others (8.2) |
Failure 24/79 vs. Success 17/68 Death (30 day) 16/47 vs. Survival 25/100 |
hVISA (37.4) |
| Studies that collected cases and isolates by the specific site of infection | |||||||||
| Sharma-Kuinkel (2012)45 | USA | 2005–2007 | 287, MR (60)/MS (40) | M | S. aureus LRTI from clinical trial comparing TV vs. VM/Post hoc analysis46 | NR | VM, TV | Failure 19/3447, 3/189 vs. Cure 60/13847, 13/969 | NR |
| Park (2013)30,e | Korea | 2008–2010 | 87, MR (100) | 1 | SAB with the removal of eradicable foci and without metastatic infections, Adult/Prospective/Post hoc analysis35 | NR | VM (95.4), LZ or TP (4.6) | PB 29/31 vs. NPB 42/56 | MIC ≥ 1.5 (48.3) |
| McDanel (2015)48 | USA | 2003–2010 | 75, MR (100) | 2 | MRSA LRTI and treated with initial VM or LZ/Retrospective | NR | VM (81.4), LZ (5.3), VM + LZ (13.3) | Death (30 day) 4/18 vs. survival 9/57 | NR |
| Gomes-Fernandes (2017)34 | Spain | NR | 18, MR (5.6)/MS(94.4) | 1 | S. aureus LRTI and control groups (nasal carriage and bacteraemiac)/Retrospective | NR | NR |
(1) PB 1/3 vs NPB 2/15 (2) Death 1/8 vs. Survival 2/10d |
|
| San-Juan (2017)49 | Spain | 2011–2014 | 83, MS (100) | 5 | Central-line-associated MSSAB/prospective | NR | NR | Complication 5/24 vs. No complication 13/56 | NR |
| Fernández-Hidalgo (2018)50 | Spain | 2013–2016 | 213, MS (81)/MR (19) | 15 | S. aureus IE (≥ 18 years)/Prospective | 213 (100) | NR | Death (in hospital) 12/589, 7/2147 vs. Survival 28/1159, 9/1947 | MIC ≥ 1.5 (35.7) |
MRSA (B), methicillin-resistant Staphylococcus aureus (bacteraemia); MSSA (B), methicillin-susceptible Staphylococcus aureus (bacteraemia); hVISA (B), heterogeneous vancomycin intermediate Staphylococcus aureus (bacteraemia); VSSA (B), vancomycin susceptible Staphylococcus aureus (bacteraemia); SAB, Staphylococcus aureus bacteraemia; PB, persistent bacteraemia; NPB, non-persistent bacteraemia; IE, infective endocarditis; LRT (I), lower respiratory tract (infection); NR, not reported; CNS, central nervous system; MIC, minimal inhibitory concentration; IQR, interquartile range; ICU, intensive care unit; GP, glycopeptide; VM, vancomycin; TP, teicoplanin; TV, telavancin; AG, aminoglycoside; RF, rifampin; DM, daptomycin; LZ, linezolid; BLT, beta-lactam.
aagr functionality was measured by agr score in this study, agr score 0–1 was considered as agr dysfunction and agr score 2–4 as agr function.
bThere is a record of the vancomycin trough level of each group, but there is no record of definite antibiotic use.
cExcluded LRTI cases in our analysis because colonization cases were mixed.
dAnalysed by 30-day mortality as an outcome using information from the researchers of the primary studies.
eExcluded from analysis because this study was conducted on selected cases from the study of Chong et al.
fStudies reported definitive therapy.
gInitial therapy as their main therapeutic agents; otherwise, therapies were not reported.