Different Types of Coagulase Are Associated With 28-Day Mortality in Patients With Bloodstream Infections.

, a leading cause of bacteremia and infective endocarditis, exploits the human coagulation system by using a wide range of specific virulence factors. However, the impact of these host-pathogen interactions on the outcome of patients with bacteremia (SAB) remains unclear. A total of 178 patients with bacteremia were included and analyzed regarding bacterial factors ( gene size, and clinical parameters. A stepwise multivariate Cox regression model and a Partitioning Around Medoids (PAM) cluster algorithm were used for statistical analysis. Patients' risk factors for 28-day mortality were creatinine (OR 1.49, < 0.001), age (OR 1.9, < 0.002), fibrinogen (OR 0.44, < 0.004), albumin (OR 0.63, < 0.02), hemoglobin (OR 0.59, < 0.03), and CRP (OR 1.72, < 0.04). Five distinct bacterial clusters with different mortality rates were unveiled, whereof two showed a 2-fold increased mortality and an accumulation of specific coagulase gene sizes, 547-base pairs and 660-base pairs. Based on the data obtained in the present study an association of coagulase gene size and regarding 28-day mortality was observed in patients with bloodstream infections. Further animal and prospective clinical studies are needed to confirm our preliminary findings.