In vitro resistance to thrombin-induced platelet microbicidal protein in isolates of Staphylococcus aureus from endocarditis patients correlates with an intravascular device source.
Platelet microbicidal proteins (PMPs) are small antimicrobial peptides secreted by mammalian platelets. In vitro resistance of Staphylococcus aureus strains to PMPs correlates with more extensive disease in experimental infective endocarditis (IE). To determine whether this same relationship exists in human S. aureus IE, we evaluated the in vitro PMP susceptibility phenotype of isolates from 58 prospectively-identified patients with definite S. aureus IE. On multivariate analyses, patients with S. aureus IE complicating an infected intravascular device were significantly more likely to have IE caused by a PMP-resistant strain (P=.0193). No correlations were detected between in vitro PMP resistance among S. aureus strains and the severity of human IE. This work supports the concept that in vitro PMP resistance in clinical S. aureus strains is associated with important clinical characteristics of S. aureus endovascular infections in vivo.
Fowler
V G
VG
Division of Infectious Diseases, Duke University Medical Center, Durham, NC 27710, USA. fowle003@mc.duke.edu
McIntyre
L M
LM
Yeaman
M R
MR
Peterson
G E
GE
Barth Reller
L
L
Corey
G R
GR
Wray
D
D
Bayer
A S
AS
D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016470:Bacteremia / Q000097:blood / Q000382:microbiology; D001798:Blood Proteins / Q000494:pharmacology*; D002408:Catheters, Indwelling / Q000009:adverse effects; D018925:Chemokines; D016001:Confidence Intervals; D004452:Echocardiography; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000097:blood / Q000382:microbiology*; D006350:Heart Valve Prosthesis / Q000009:adverse effects; D006801:Humans; D008826:Microbial Sensitivity Tests; D015999:Multivariate Analysis; D006435:Renal Dialysis / Q000009:adverse effects; D013203:Staphylococcal Infections / Q000097:blood / Q000209:etiology / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification; D001620:beta-Thromboglobulin
D000900:Anti-Bacterial Agents; D001798:Blood Proteins; D018925:Chemokines; C061615:PPBP protein, human; D001620:beta-Thromboglobulin