Yoon Hee Jung, Choi Jun Yong, Lee Kyungwon, Yong Dongeun, Kim June Myung, Song Young Goo
Department of Internal Medicine, Yongdong Severance Hospital, Yonsei University College of Medicine, 146-92 Dogok-Dong, Kangnam-Gu, Seoul, Korea.
Yonsei Med J. 2007 Apr 30;48(2):176-83. doi: 10.3349/ymj.2007.48.2.176.
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.
A total of 158 clinical isolates were evaluated by RFLPs (restriction fragment length polymorphisms).
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).
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.
金黄色葡萄球菌中的毒力基因表达受诸如辅助基因调节子（agr）等调节因子控制。根据agrD和agrC多态性，菌株可分为四个主要的agr组（agr I-IV）。本研究的目的是确定agr I、II和III多态性的比例，并比较韩国一家三级护理教学医院中耐甲氧西林金黄色葡萄球菌（MRSA）菌株I组与非I组多态性之间的临床特征。
通过限制性片段长度多态性（RFLPs）对总共158株临床分离株进行评估。
患者的平均年龄为50.2±21.9岁。agr I组、II组、III组、I+II组和I+III多态性的菌株分别有74株（49.3%）、66株（44.0%）、10株（6.7%）、7株（4.4%）和1株（0.6%）。根据单因素分析（p=0.001）和多因素分析（OR，4.721（1.273-17.508），p=0.020），只有耳部感染是具有统计学意义的临床参数。
本研究表明，agr I组在韩国最为普遍，耳部感染与I组多态性相关，这与西方国家不同的临床趋势。还可以推断社区获得性MRSA与agr I组相关。
