{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T20:39:10Z","timestamp":1790627950172,"version":"4.1.0"},"reference-count":49,"publisher":"American Society for Microbiology","issue":"6","license":[{"start":{"date-parts":[[2015,6,1]],"date-time":"2015-06-01T00:00:00Z","timestamp":1433116800000},"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":[[2015,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Staphylococcal cassette chromosome\n            <jats:italic>mec<\/jats:italic>\n            element (SCC\n            <jats:italic>mec<\/jats:italic>\n            ) type-dependent clinical outcomes may vary due to geographical variation in the presence of virulence determinants. We compared the microbiological factors and mortality attributed to methicillin-resistant\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Staphylococcus aureus<\/jats:named-content>\n            (MRSA) bacteremia between SCC\n            <jats:italic>mec<\/jats:italic>\n            types II\/III and type IV. All episodes of MRSA bacteremia in a tertiary-care hospital (South Korea) over a 4.5-year period were reviewed. We studied the microbiological factors associated with all blood MRSA isolates, including\n            <jats:italic>spa<\/jats:italic>\n            type,\n            <jats:italic>agr<\/jats:italic>\n            type,\n            <jats:italic>agr<\/jats:italic>\n            dysfunction, and the genes for Panton-Valentine leukocidin (PVL) and phenol-soluble modulin (PSM)-mec, in addition to SCC\n            <jats:italic>mec<\/jats:italic>\n            type. Of 195 cases, 137 involved SCC\n            <jats:italic>mec<\/jats:italic>\n            types II\/III, and 58 involved type IV. The mortality attributed to MRSA bacteremia was less frequent among the SCC\n            <jats:italic>mec<\/jats:italic>\n            type IV (5\/58) than that among types II\/III (39\/137,\n            <jats:italic>P<\/jats:italic>\n            = 0.002). This difference remained significant when adjusted for clinical factors (adjusted odds ratio [aOR], 0.14; 95% confidence interval [CI], 0.04 to 0.49;\n            <jats:italic>P<\/jats:italic>\n            = 0.002). Of the microbiological factors tested,\n            <jats:italic>agr<\/jats:italic>\n            dysfunction was the only significant factor that showed different positivity between the SCC\n            <jats:italic>mec<\/jats:italic>\n            types, and it was independently associated with MRSA bacteremia-attributed mortality (aOR, 4.71; 95% CI, 1.72 to 12.92;\n            <jats:italic>P<\/jats:italic>\n            = 0.003). SCC\n            <jats:italic>mec<\/jats:italic>\n            type IV is associated with lower MRSA bacteremia-attributed mortality than are types II\/III, which might be explained by the high rate of\n            <jats:italic>agr<\/jats:italic>\n            dysfunction in SCC\n            <jats:italic>mec<\/jats:italic>\n            types II\/III in South Korea.\n          <\/jats:p>","DOI":"10.1128\/aac.04962-14","type":"journal-article","created":{"date-parts":[[2015,3,17]],"date-time":"2015-03-17T02:56:01Z","timestamp":1426560961000},"page":"3125-3132","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":23,"title":["<i>agr<\/i>\n            Dysfunction Affects Staphylococcal Cassette Chromosome\n            <i>mec<\/i>\n            Type-Dependent Clinical Outcomes in Methicillin-Resistant Staphylococcus aureus Bacteremia"],"prefix":"10.1128","volume":"59","author":[{"given":"Chang Kyung","family":"Kang","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea"},{"name":"Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeong Eun","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoon Jeong","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Younghee","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea"},{"name":"Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nak-Hyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chung-Jong","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea"},{"name":"Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taek Soo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyoung-Ho","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea"},{"name":"Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pyoeng Gyun","family":"Choe","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan Beom","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji-Hwan","family":"Bang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eu Suk","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea"},{"name":"Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyoung Un","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang 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