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Background:   Staphylococcus aureus (S. aureus) , 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  Staphylococcus aureus  bacteremia (SAB) remains unclear.   Methods:  A total of 178 patients with  S. aureus  bacteremia were included and analyzed regarding bacterial factors ( coa  gene size,  vWbp, clfA, clfB, fnbA, fnbB, fib)  and clinical parameters. A stepwise multivariate Cox regression model and a Partitioning Around Medoids (PAM) cluster algorithm were used for statistical analysis.   Results:  Patients' risk factors for 28-day mortality were creatinine (OR 1.49,  p  < 0.001), age (OR 1.9,  p  < 0.002), fibrinogen (OR 0.44,  p  < 0.004), albumin (OR 0.63,  p  < 0.02), hemoglobin (OR 0.59,  p  < 0.03), and CRP (OR 1.72,  p  < 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.   Conclusions:  Based on the data obtained in the present study an association of coagulase gene size and  fib  regarding 28-day mortality was observed in patients with  S. aureus  bloodstream infections. Further animal and prospective clinical studies are needed to confirm our preliminary findings.

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