{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T07:45:38Z","timestamp":1791099938812,"version":"4.1.0"},"reference-count":41,"publisher":"American Society for Microbiology","issue":"3","license":[{"start":{"date-parts":[[2011,3,1]],"date-time":"2011-03-01T00:00:00Z","timestamp":1298937600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2011,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Accessory gene regulator (\n            <jats:italic>agr<\/jats:italic>\n            ) dysfunction in\n            <jats:italic>Staphylococcus aureus<\/jats:italic>\n            has been associated with a longer duration of bacteremia. We aimed to assess the independent association between\n            <jats:italic>agr<\/jats:italic>\n            dysfunction in\n            <jats:italic>S. aureus<\/jats:italic>\n            bacteremia and 30-day in-hospital mortality. This retrospective cohort study included all adult inpatients with\n            <jats:italic>S. aureus<\/jats:italic>\n            bacteremia admitted between 1 January 2003 and 30 June 2007. Severity of illness prior to culture collection was measured using the modified acute physiology score (APS).\n            <jats:italic>agr<\/jats:italic>\n            dysfunction in\n            <jats:italic>S. aureus<\/jats:italic>\n            was identified semiquantitatively by using a \u03b4-hemolysin production assay. Cox proportional hazard models were used to measure the association between\n            <jats:italic>agr<\/jats:italic>\n            dysfunction and 30-day in-hospital mortality, statistically adjusting for patient and pathogen characteristics. Among 814 patient admissions complicated by\n            <jats:italic>S. aureus<\/jats:italic>\n            bacteremia, 181 (22%) patients were infected with\n            <jats:italic>S. aureus<\/jats:italic>\n            isolates with\n            <jats:italic>agr<\/jats:italic>\n            dysfunction. Overall, 18% of patients with\n            <jats:italic>agr<\/jats:italic>\n            dysfunction in\n            <jats:italic>S. aureus<\/jats:italic>\n            died, compared to 12% of those with functional\n            <jats:italic>agr<\/jats:italic>\n            in\n            <jats:italic>S. aureus<\/jats:italic>\n            (\n            <jats:italic>P<\/jats:italic>\n            = 0.03). There was a trend toward higher mortality among patients with\n            <jats:italic>S. aureus<\/jats:italic>\n            with\n            <jats:italic>agr<\/jats:italic>\n            dysfunction (adjusted hazard ratio [HR], 1.34; 95% confidence interval [CI], 0.87 to 2.06). Among patients with the highest APS (scores of &gt;28),\n            <jats:italic>agr<\/jats:italic>\n            dysfunction in\n            <jats:italic>S. aureus<\/jats:italic>\n            was significantly associated with mortality (adjusted HR, 1.82; 95% CI, 1.03 to 3.21). This is the first study to demonstrate an independent association between\n            <jats:italic>agr<\/jats:italic>\n            dysfunction and mortality among severely ill patients. The \u03b4-hemolysin assay examining\n            <jats:italic>agr<\/jats:italic>\n            function may be a simple and inexpensive approach to predicting patient outcomes and potentially optimizing antibiotic therapy.\n          <\/jats:p>","DOI":"10.1128\/aac.00918-10","type":"journal-article","created":{"date-parts":[[2010,12,21]],"date-time":"2010-12-21T06:06:50Z","timestamp":1292911610000},"page":"1082-1087","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":138,"title":["Increased Mortality with Accessory Gene Regulator (\n            <i>agr<\/i>\n            ) Dysfunction in\n            <i>Staphylococcus aureus<\/i>\n            among Bacteremic Patients"],"prefix":"10.1128","volume":"55","author":[{"given":"Marin L.","family":"Schweizer","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, Maryland"},{"name":"University of Iowa Carver College of Medicine, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon P.","family":"Furuno","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Sakoulas","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of San Diego School of Medicine, La Jolla, California"},{"name":"Department of Medicine, Sharp Memorial Hospital, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Kristie","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony D.","family":"Harris","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle D.","family":"Shardell","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessina C.","family":"McGregor","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, College of Pharmacy, Oregon State University\/Oregon Health &amp; Science University, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerri A.","family":"Thom","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eli N.","family":"Perencevich","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, Maryland"},{"name":"University of Iowa Carver College of Medicine, Iowa City, Iowa"},{"name":"Iowa City Veterans Affairs Medical Center, Iowa City, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/48.suppl_1.5"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.md.0000091185.93122.40"},{"key":"e_1_3_3_4_2","unstructured":"Performance standards for 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