Original Article
Use of a Staphylococcus aureus Conjugate Vaccine in Patients Receiving Hemodialysis
N Engl J Med 2002; 346:491-496February 14, 2002
- Abstract
Background
In patients with decreased resistance to infection, Staphylococcus aureus is a major cause of bacteremia and its complications. The capsular polysaccharides are essential for the pathogenesis of and immunity to S. aureus infection and are targets for vaccines.
Methods
In a double-blind trial involving patients with end-stage renal disease who were receiving hemodialysis, we evaluated the safety, immunogenicity, and efficacy of a vaccine with S. aureus type 5 and 8 capsular polysaccharides conjugated to nontoxic recombinant Pseudomonas aeruginosa exotoxin A. Between April 1998 and August 1999, 1804 adult patients at 73 hemodialysis centers were randomly assigned to receive a single intramuscular injection of either vaccine or saline. IgG antibodies to S. aureus type 5 and 8 capsular polysaccharides were measured for up to two years, and episodes of S. aureus bacteremia were recorded. Efficacy was estimated by comparing the incidence of S. aureus bacteremia in the patients who received the vaccine with the incidence in the control patients.
Results
Reactions to the vaccine were generally mild to moderate, and most resolved within two days. The capsular polysaccharides elicited an antibody response of at least 80 μg per milliliter (the estimated minimal level conferring protection) in 80 percent of patients for type 5 and in 75 percent of patients for type 8. The efficacy during weeks 3 to 54 was only 26 percent (P=0.23). However, between weeks 3 and 40 after vaccination, S. aureus bacteremia developed in 11 of 892 patients in the vaccine group who could be evaluated for bacteremia, as compared with 26 of 906 patients in the control group (estimate of efficacy, 57 percent; 95 percent confidence interval, 10 to 81 percent; nominal P=0.02).
Conclusions
In patients receiving hemodialysis, a conjugate vaccine can confer partial immunity against S. aureus bacteremia for approximately 40 weeks, after which protection wanes as antibody levels decrease.
Media in This Article
Figure 1
Kaplan–Meier Survival Curves for Staphylococcus aureus Bacteremia after Week 2.Table 1
Summary of Reactions to the Vaccine.Article Activity
- Article
Staphylococcus aureus is a major cause of nosocomial and community-acquired infections, including bacteremia, metastatic abscesses, septic arthritis, endocarditis, osteomyelitis, and wound infections.1-3 A study of hospitalized patients in 1995 found that the death rate, the length of stay, and the medical costs were twice as high for S. aureus–associated hospitalizations as for other hospitalizations.4 Among patients receiving hemodialysis, S. aureus bacteremia is a prominent cause of complications and death, with an annual incidence of 3 to 4 percent.5 An increasing percentage of isolates are resistant to methicillin6 and show relative resistance to vancomycin.7 Hence, immunoprophylaxis against S. aureus is a worthwhile objective.
The capsular polysaccharides of S. aureus are virulence factors in systemic infections. S. aureus capsular polysaccharides confer invasiveness by inhibiting opsonophagocytic killing by polymorphonuclear neutrophils; this pattern is similar to that in other encapsulated bacteria, such as Streptococcus pneumoniae.8 Of the 12 known types of S. aureus, types 5 and 8 account for approximately 85 percent of all clinical isolates.9-12 Antibodies to the capsular polysaccharides of S. aureus types 5 and 8 induce type-specific opsonophagocytic killing by human polymorphonuclear neutrophils in vitro and confer protection in animals.13,14
S. aureus capsular polysaccharides alone are poor immunogens. Their immunogenicity is enhanced by conjugation with carrier proteins.15-17 Monovalent vaccines containing S. aureus type 5 or type 8 capsular polysaccharide bound to recombinant exoprotein A, a nontoxic variant of Pseudomonas aeruginosa exotoxin A expressed in Escherichia coli, are immunogenic and well tolerated in healthy adults and in patients with end-stage renal disease.18 In a prior study of patients with end-stage renal disease who were receiving peritoneal dialysis, a low dose of a conjugate antistaphylococcal vaccine was not efficacious. Therefore, we evaluated a higher dose of a bivalent conjugate vaccine composed of type 5 and 8 capsular polysaccharides covalently bound to recombinant exoprotein A. The goal of this controlled study was to evaluate the vaccine in terms of safety, immunogenicity, and ability to prevent bacteremia in patients receiving hemodialysis.
Methods
Patients
Patients were recruited at 73 hemodialysis centers in California from April 1998 to August 1999. Enrolled patients were 18 years of age or older, had end-stage renal disease, had received hemodialysis with vascular access through a native-vessel fistula or a synthetic or heterologous graft for at least eight weeks before enrollment, had a Karnofsky score of at least 50 at entry, and were expected to complete the required follow-up visits.
Criteria for exclusion were symptoms or signs consistent with an infection within two weeks before vaccination, a history of infection with the human immunodeficiency virus, hypersensitivity or previous anaphylaxis caused by polysaccharides or polysaccharide conjugate vaccines, drug abuse within one year before vaccination, use of immunosuppressive or immunomodulatory drugs, and cancer or treatment for cancer within six months before vaccination. The study protocol was approved by the institutional review boards of the Kaiser Foundation Research Institute, Southern California Kaiser Permanente, and El Camino Hospital and by the Food and Drug Administration. The study was designed by the investigators, an independent data and safety monitoring board, and the manufacturer. The data were held by the data and safety monitoring board and analyzed by a group of the authors. The manuscript was a collaborative effort of all the listed authors. All patients gave written informed consent.
Study Design
Eligible patients were randomly assigned to receive a single injection of vaccine or saline placebo. Randomization was stratified according to the type of vascular access (native-vessel fistula or synthetic or heterologous graft) and the presence or absence of persistent nasal carriage of S. aureus.
The vaccine (StaphVAX, Nabi, Rockville, Md.) is composed of S. aureus type 5 and 8 capsular polysaccharides (100 μg per milliliter of each type) conjugated to an equal weight of recombinant exoprotein A in 0.01 percent polysorbate 80 and sodium phosphate-buffered saline (pH 7.4). The dose was selected on the basis of our previous studies in patients with end-stage renal disease (unpublished data). Vaccine and placebo (sodium phosphate-buffered saline) were supplied as 1 ml of clear liquid in identical vials, each bearing a unique code.
In two screening visits that took place approximately one week apart, subjects were evaluated for eligibility, and the anterior nares were cultured for S. aureus. Carriage was defined by two positive cultures. The vaccine or placebo was administered by intramuscular injection into the deltoid muscle or the anterior thigh.
Patients were evaluated 30 minutes after the injection and instructed to record local reactions (e.g., redness, swelling, aching, burning, tenderness, and heat) and systemic reactions (e.g., fever, general discomfort, muscle ache, headache, nausea, and vomiting) each day for one week. One week after injection, patients returned to the dialysis center, and reactions to the vaccine were recorded. Patients were evaluated for adverse events for up to six weeks after the injection. Deaths and all episodes of bacteremia were recorded until the study ended or the patient withdrew. The primary outcome measure was the first occurrence of S. aureus bacteremia in a patient. Blood cultures were obtained before antibiotic therapy was begun.
Serum samples were obtained before and 6, 26, 54, and 67 weeks after vaccination. Antibodies to the S. aureus type 5 and 8 capsular polysaccharides were measured by enzyme-linked immunosorbent assay.15,19 A response to the vaccine was defined as an antibody level of at least 25 μg per milliliter and at least twice the level before vaccination.
Determination of Sample Size
Surveys in the United States and Europe suggested an incidence rate of S. aureus bacteremia of 0.03 to 0.04 per patient-year in those receiving hemodialysis.5,20-22 A sample size of 900 patients per group was determined to be sufficient to detect, with 80 percent power, a 60 percent reduction in the incidence of S. aureus bacteremia in the vaccine group during an observation period from 3 to 54 weeks after vaccination. However, since the antibody correlate of protection was not known before the study, and since antibody levels decline rapidly in patients with end-stage renal disease, other observation periods were evaluated.
Statistical Analysis
Evaluation of efficacy was based on data obtained two weeks after vaccination. The rate of S. aureus bacteremia was compared between the vaccine and control groups by an exact, stratified analysis with the use of StatXact software.23,24 Four groups were created by the stratification of patients according to nasal-carriage status at base line and type of vascular access. The time to the first episode of S. aureus bacteremia was determined by the Kaplan–Meier method and compared by a stratified log-rank test.
Since the potential duration of protection that might be provided by the staphylococcal conjugate vaccine was not known a priori, the effectiveness of the vaccine was evaluated in a post hoc analysis, and nominal P values have been reported. To compute a valid P value for this analysis, a permutation analysis based on the observed data was performed. This analysis, based on a two-sample permutation test, was used to determine the time elapsed since vaccination with the highest log-rank statistic — a measure of the difference between the vaccine and placebo groups in the time to S. aureus bacteremia. A total of 2000 simulated data sets were generated from all 1798 subjects who received an injection and could be evaluated for bacteremia to examine the log-rank statistic in weeks 3 to 4, weeks 3 to 5, and so on up to weeks 3 to 54. The P value for the null hypothesis of no vaccine effect was calculated as the proportion of simulated data sets that yielded a log-rank statistic greater than the greatest statistic yielded by the observed data set.
The numbers of patients who had reactions to the injection and who died in the vaccine and placebo groups were compared by Fisher's exact test. No adjustments were made for the multiplicity of tests of safety. To estimate the level of antibody that conferred protection (the correlate of protection), the antibody level was interpolated from the data generated before and 6, 26, and 54 weeks after immunization to estimate the mean antibody level at the point beyond which protective efficacy was no longer observed.
Results
A total of 1804 of 1991 screened patients recruited at the 73 hemodialysis centers were enrolled; 894 were randomly assigned to receive vaccine and 910 to receive placebo. Among 187 screened patients who were not immunized, 81 did not meet the eligibility criteria or did not comply with the protocol, 71 withdrew consent, 22 had a change in health status, and 13 were not included for other reasons. The study period was from April 1998 to April 2000. The patients who received the vaccine and the control patients participated in the study for a median of 75 weeks and 74 weeks, respectively; 76 percent of the patients in each group participated in the study for at least 54 weeks. Six patients were excluded from the study after randomization; three control patients died within the first two weeks, and two patients who received the vaccine and one control patient had infections within two weeks before the injection. No patient was excluded from the analysis of safety.
The two groups were similar with regard to pretreatment demographic and clinical characteristics and were representative of the diverse population of California. Thirty-three percent of the patients were white, 31 percent were Hispanic, 23 percent were black, and 13 percent were Asian. Among the 894 patients who received the vaccine and the 910 control patients, 46 percent and 44 percent were women and 52 percent and 51 percent had diabetes, respectively. At vaccination, 69 percent of the patients in both groups had vascular access through a graft, and 22 percent had nasal carriage of S. aureus. The mean age in both groups was 58.3 years.
Reactions to the Vaccine and Other Adverse Events
There were no statistically significant differences in the number of deaths between the vaccine and control groups, and none of the deaths were considered to be related to the vaccine. The incidence of local reactions, malaise, and myalgia was significantly higher in patients who received the vaccine than in control patients (Table 1Table 1
Summary of Reactions to the Vaccine.). Local reactions were generally mild or moderate and resolved within two days. A causal or temporal relation between S. aureus bacteremia and death was identified for 9 of the 152 deaths (5.9 percent) in the vaccine group and 11 of the 146 deaths (7.5 percent) in the control group (P=0.65 according to Fisher's exact test).S. aureus Bacteremia
The overall trend in the incidence of infection is shown in Figure 1Figure 1
Kaplan–Meier Survival Curves for Staphylococcus aureus Bacteremia after Week 2.. In weeks 1 and 2 after vaccination and before the start of follow-up to assess the efficacy of the vaccine, there was one patient with bacteremia in the vaccine group and none in the placebo group. In terms of the primary hypothesis that the vaccine would protect against infection during weeks 3 to 54, there were no statistically significant differences between the groups; the efficacy of the vaccine for this period was 26 percent (95 percent confidence interval, –24 to 57 percent; P=0.23) (Table 2Table 2
Cumulative Number of Patients in Whom Staphylococcus aureus Bacteremia Developed and Efficacy of the Vaccine.). We then investigated the data for other intervals during which the effect of the vaccine was more substantial. We found that during weeks 3 to 40, when 11 events occurred during 618.9 person-years in patients who received the vaccine and 26 events occurred during 627.0 person-years in control patients, the vaccine reduced the incidence of bacteremia by 57 percent (95 percent confidence interval, 10 to 81 percent; nominal P=0.02). With the permutation test used to account for the lack of an a priori hypothesis for a shorter interval of protection, the highest log-rank statistic was 7.03 for the interval of 3 to 32 weeks with a P value of 0.05.Tests for homogeneity of efficacy during weeks 3 to 91 showed that efficacy was not significantly different across the four groups created by stratification (P=0.15 for an exact test of homogeneity). However, our study had limited power to evaluate this interaction. In both groups, patients with vascular access through a graft rather than a fistula at the start of the study tended to be at increased risk for bacteremia (Table 3Table 3
Incidence of Staphylococcus aureus Bacteremia Developed during Weeks 3 to 54, According to Type of Vascular Access, Nasal-Carriage Status, and Treatment Group.). Nasal carriage of S. aureus also tended to be associated with an increased risk of bacteremia in control patients (7.6 vs. 3.1 per 100 person-years, P=0.06 according to an exact comparison of person-time rates) but not in patients who received the vaccine.The vaccine and control groups had a similar distribution of types of S. aureus among patients with bacteremia. It was possible to retrieve 24 of 37 isolates from the vaccine group and 37 of 49 isolates from the control group for typing. In the vaccine group, 8 isolates (33 percent) were type 5 and 11 (46 percent) were type 8. Five (21 percent) were type 336, a recently described surface polysaccharide.25,26 In the placebo group, 10 isolates (27 percent) were type 5, 20 (54 percent) were type 8, and 7 (19 percent) were type 336. Methicillin resistance was found in 7 of 37 S. aureus isolates in the vaccine group and 12 of 48 in the placebo group (1 isolate from a control patient was not tested). Between weeks 3 and 40, there were 37 episodes of S. aureus bacteremia (11 in the vaccine group and 26 in the placebo group). It was possible to retrieve 9 of 11 isolates from the vaccine group and 20 of 26 from the placebo group for typing. In the vaccine group, there were five type 5, three type 8, and one type 336 isolates. In the placebo group, there were 6 type 5, 11 type 8, and 3 type 336 isolates (P=0.50 according to the exact chi-square test). Between weeks 3 and 54, there were two patients who received the vaccine and six control patients who had more than one episode of bacteremia (P=0.11 according to the exact Cochran–Mantel–Haenszel test).
Relation between Antibody Levels and S. aureus Bacteremia
In our analysis, vaccine efficacy was observed for 40 weeks after receipt of the vaccine. We estimated the geometric mean antibody level in patients who received the vaccine to be approximately 80 μg per milliliter at 40 weeks, and this is a crude estimate of the correlate of protection in our population. For the vaccine and placebo groups, the peak geometric mean levels of antibodies to type 5 and type 8 capsular polysaccharides were not significantly different between those patients with and those without bacteremia.
Antibody Levels
There were no statistically significant differences in antibody levels before vaccination between the vaccine and placebo groups. Antibodies remained at prevaccination levels in the placebo group. In the vaccine group, the geometric mean antibody levels were 230.0 μg per milliliter for type 5 capsular polysaccharide and 206.0 μg per milliliter for type 8 capsular polysaccharide at week 6 (the first time point evaluated), and they declined thereafter (Table 4Table 4
Geometric Mean Levels of Antibodies Specific for Staphylococcus aureus Type 5 and 8 Capsular Polysaccharides.). The percentages of patients with a peak antibody level of at least 80 μg per milliliter (the estimated minimal protective level) were 80 percent for type 5 capsular polysaccharide and 75 percent for type 8 capsular polysaccharide. Included among the patients with no response were 27 patients (3 percent) for whom data were not available.Discussion
This randomized, double-blind, placebo-controlled study demonstrates that a single injection of a conjugate vaccine containing S. aureus type 5 and type 8 capsular polysaccharides is safe and immunogenic and provides some protection for approximately 40 weeks against S. aureus bacteremia in patients with end-stage renal disease, an immunocompromised population at especially high risk for S. aureus bacteremia.5,20-22 Nearly 90 percent of the patients receiving hemodialysis had a response to the vaccine, and in over 75 percent antibody levels reached at least 80 μg per milliliter (the estimated minimal level for protection). The decrease in vaccine efficacy after week 40 paralleled the decrease in levels of specific antibodies in the patient population. Antibody levels decline rapidly in patients receiving hemodialysis, and booster doses of vaccine should be evaluated.
In previous studies, vaccination with 25 μg of a monovalent conjugated S. aureus type 5 capsular polysaccharide induced a geometric mean level of antibody to type 5 capsular polysaccharide of 318 μg per milliliter in healthy subjects17 and 180 μg per milliliter in patients receiving hemodialysis.18 Since this vaccine was more immunogenic in immunocompetent subjects, it could in theory provide equal or better protection against systemic infection with S. aureus for patients about to undergo elective surgery.
We estimated the minimal level at which protection was conferred by antibodies in patients with end-stage renal disease to be 80 μg per milliliter, which is 2 to 3 logs higher than the levels at which protection is conferred by antibodies to Haemophilus influenzae type b capsular polysaccharide and S. pneumoniae capsular polysaccharides (0.15 and 1 μg per milliliter, respectively).27,28 The differences in the protective level of antibodies may be attributable to impaired phagocyte function and underlying disease in patients with end-stage renal disease.29 Thus, identification of a protective level of antibodies for this patient population provides a surrogate for clinical efficacy of this vaccine in other at-risk patients. For immunocompetent adults, the protective levels of antibodies may be lower than those required for patients with end-stage renal disease.
The distribution of the types of S. aureus isolates from patients with bacteremia in this study was consistent with results reported by others.9-12 The similar distribution of methicillin resistance among isolates from both the vaccine and placebo groups is consistent with in vitro data showing that both antibiotic-resistant and antibiotic-sensitive strains of S. aureus are killed by antibody-mediated opsonophagocytosis.
For 40 weeks after vaccination, the bivalent vaccine induced protection against S. aureus bacteremia. In addition, the efficacy of the vaccine was statistically significant during a 32-week period in the simulation model that took into account the lack of an a priori hypothesis for the duration of the vaccine effect. It is possible that efficacy will increase after the addition of the newly described type 336 to the vaccine.
The results of this study show that conjugate-induced antibodies to S. aureus capsular polysaccharides can provide partial protection against S. aureus bacteremia. Because patients receiving hemodialysis are among the least likely to have a response to immunoprophylaxis, the efficacy of the vaccine may be similar or perhaps greater in other patient populations.
Supported by Nabi, Boca Raton, Fla.
Dr. Muenz has served as a paid consultant to Nabi.
Source Information
From the Kaiser Permanente Vaccine Study Center, Oakland, Calif. (H.S., S.B., J.O., D.L.); Nabi, Rockville, Md. (A.F., G.H., R.N.); Southern California Kaiser Permanente, Los Angeles (S.R., H.Y.); the National Institute of Child Health and Human Development, Bethesda, Md. (J.B.R., R.S.); and Larry Muenz and Associates, Rockville, Md. (L.M.).
Address reprint requests to Dr. Shinefield at the Kaiser Permanente Vaccine Study Center, 1 Kaiser Plaza, 16th Fl., Oakland, CA 94612, or at henry.shinefield@kp.org.
Other authors were Steve Fuller, Ph.D., Nabi, Rockville, Md.; Joanie Johnson, R.N., and Bruce Fireman, M.A., Kaiser Permanente, Oakland, Calif.; and Harry Alcorn, Pharm.D., Total Renal Research, Minneapolis.
- References
References
1
Richards MJ, Edwards JR, Culver DH, Gaynes RP, National Nosocomial Infections Surveillance System
CrossRef | Web of Science | Medline2
Goetz A ,Posey K ,Fleming J , et al. Methicillin-resistant Staphylococcus aureus in the community: a hospital-based study. Infect Control Hosp Epidemiol 1999;20:689-691
CrossRef | Web of Science | Medline3
Lowy FD . Staphylococcus aureus infections. N Engl J Med 1998;339:520-532
Full Text | Web of Science | Medline4
Rubin RJ ,Harrington CA ,Poon A ,Dietrich K ,Greene JA ,Moiduddin A . The economic impact of Staphylococcus aureus infection in New York City hospitals. Emerg Infect Dis 1999;5:9-17
CrossRef | Web of Science | Medline5
Kessler M ,Hoen B ,Mayeux D ,Hestin D ,Fontenaille C . Bacteremia in patients on chronic hemodialysis: a multicenter prospective survey. Nephron 1992;64:95-100
CrossRef6
Archer GL ,Climo MW . Staphylococcus aureus bacteremia -- consider the source. N Engl J Med 2001;344:55-56
Full Text | Web of Science | Medline7
Smith TL ,Pearson ML ,Wilcox KR , et al. Emergence of vancomycin resistance in Staphylococcus aureus. N Engl J Med 1999;340:493-501
Full Text | Web of Science | Medline8
Karakawa WW ,Vann WF . Capsular polysaccharides of Staphylococcus aureus. Semin Infect Dis 1982;4:285-2939
Karakawa WW ,Fournier JM ,Vann WF ,Arbeit R ,Schneerson RS ,Robbins JB . Method for the serological typing of the capsular polysaccharides of Staphylococcus aureus. J Clin Microbiol 1985;22:445-447
Web of Science | Medline10
Arbeit RD ,Karakawa WW ,Vann WW ,Robbins JB . Predominance of two newly described capsular polysaccharide types among clinical isolates of Staphylococcus aureus. Diagn Microbiol Infect Dis 1984;2:85-91
CrossRef | Web of Science | Medline11
Na'was T ,Hawwari A ,Hendrix E , et al. Phenotypic and genotypic characterization of nosocomial Staphylococcus aureus isolates from trauma patients. J Clin Microbiol 1998;36:414-420
Web of Science | Medline12
Essawi T ,Na'was T ,Hawwari A ,Wadi S ,Doudin A ,Fattom AI . Molecular, antibiogram and serological typing of Staphylococcus aureus isolates recovered from Al-Makased hospital in East Jerusalem. Trop Med Int Health 1998;3:576-583
CrossRef | Web of Science | Medline13
Karakawa WW ,Sutton A ,Schneerson R ,Karpas A ,Vann WF . Capsular antibodies induce type-specific phagocytosis of capsulated Staphylococcus aureus by human polymorphonuclear leukocytes. Infect Immun 1988;56:1090-1095
Web of Science | Medline14
Fattom AI ,Sarwar J ,Ortiz A ,Naso R . Staphylococcus aureus capsular polysaccharide (CP) vaccine and CP-specific antibodies protect mice against bacterial challenge. Infect Immun 1996;64:1659-1665
Web of Science | Medline15
Fattom A ,Schneerson R ,Szu SC , et al. Synthesis and immunologic properties in mice of vaccines composed of Staphylococcus aureus type 5 and type 8 capsular polysaccharides conjugated to Pseudomonas aeruginosa exotoxin A. Infect Immun 1990;58:2367-2374
Web of Science | Medline16
Robbins JB ,Schneerson R ,Vann WF ,Bryla DA ,Fattom A . Prevention of systemic infections caused by group B streptococcus and Staphylococcus aureus by multivalent polysaccharide-protein conjugate vaccines. Ann N Y Acad Sci 1995;754:68-82
CrossRef | Web of Science | Medline17
Fattom A ,Shiloach J ,Bryla D , et al. Comparative immunogenicity of conjugates composed of the Staphylococcus aureus type 8 capsular polysaccharide bound to carrier proteins by adipic acid dihydrazide or N-succinimidyl-3-(2-pyridyldithio)propionate. Infect Immun 1992;60:584-589
Web of Science | Medline18
Welch PG ,Fattom A ,Moore J Jr , et al. Safety and immunogenicity of Staphylococcus aureus type 5 capsular polysaccharide-Pseudomonas aeruginosa recombinant exoprotein A conjugate vaccine in patients on hemodialysis. J Am Soc Nephrol 1996;7:247-253
Web of Science | Medline19
Fattom A ,Schneerson R ,Watson DC , et al. Laboratory and clinical evaluation of conjugate vaccines composed of Staphylococcus aureus type 5 and type 8 capsular polysaccharides bound to Pseudomonas aeruginosa recombinant exoprotein A. Infect Immun 1993;61:1023-1032
Web of Science | Medline20
Quarles LD ,Rutsky EA ,Rostand SG . Staphylococcus aureus bacteremia in patients on chronic hemodialysis. Am J Kidney Dis 1985;6:412-419
Web of Science | Medline21
Roubicek C ,Brunet P ,Mallet MN , et al. Portage nasal de Staphylococcus aureus: prévalence dans un centre d'hémodialyse et influence sur les bactériémies. Nephrologie 1995;16:229-232
Medline22
Bloembergen WE ,Port FK . Epidemiological perspective on infections in chronic dialysis patients. Adv Ren Replace Ther 1996;3:201-207
Medline23
Software manual for StatXact-4. Cambridge, Mass.: Cytel, 1998.
24
Breslow NE, Day NE. Statistical methods in cancer research. Vol. 2. The design and analysis of cohort studies. Lyon, France: International Agency for Research on Cancer, 1987. (IARC scientific publications no. 82.)
25
Fattom A ,Guidry A . Questions uniqueness of surface polysaccharide. Am J Vet Res 1999;60:530-530
Web of Science | Medline26
Robbins JB ,Parke JC Jr ,Schneerson R ,Whisnant JK . Quantitative measurement of “natural“ and immunization-induced Haemophilus influenzae type b capsular polysaccharide antibodies. Pediatr Res 1973;7:103-110
CrossRef | Web of Science | Medline27
Landesman SH ,Schiffman G . Assessment of the antibody response to pneumococcal vaccine in high-risk populations. Rev Infect Dis 1981;3:Suppl:S184-S196
CrossRef | Medline28
Chou M-Y ,Shian L-R ,Chang F-Y ,Shaio M-F . Opsonophagocytosis of Staphylococcus aureus by diabetics' sera and monocytes. Taiwan Yi Xue Hui Za Zhi 1989;88:352-359
Medline29
Hoen B, Kessler M, Paul-Dauphin A. Lack of association between staphylococcal nasal carriage (SNC) and bacteremia in chronic hemodialysis patients. In: Program and abstracts of the 36th Interscience Conference on Antimicrobial Agents and Chemotherapy, New Orleans, September 15–18, 1996. Washington, D.C.: American Society for Microbiology 1996:233. abstract.
- Citing Articles (124)
Citing Articles
1
Robert Skov, Keryn Christiansen, Stephanie J. Dancer, Robert S. Daum, Matthew Dryden, Yhu-Chering Huang, Franklin D. Lowy. (2012) Update on the prevention and control of community-acquired meticillin-resistant Staphylococcus aureus (CA-MRSA). International Journal of Antimicrobial Agents
CrossRef2
R. S. Daum, B. Spellberg. (2011) Progress Toward a Staphylococcus aureus Vaccine. Clinical Infectious Diseases
CrossRef3
Steven Y. C. Tong, Luke F. Chen, Vance G. Fowler. (2011) Colonization, pathogenicity, host susceptibility, and therapeutics for Staphylococcus aureus: what is the clinical relevance?. Seminars in Immunopathology
CrossRef4
Andrea DeDent, Hwan Keun Kim, Dominique Missiakas, Olaf Schneewind. (2011) Exploring Staphylococcus aureus pathways to disease for vaccine development. Seminars in Immunopathology
CrossRef5
Clayton D. Harro, Robert F. Betts, Jonathan S. Hartzel, Matthew T. Onorato, Joy Lipka, Steven S. Smugar, Nicholas A. Kartsonis. (2011) The immunogenicity and safety of different formulations of a novel Staphylococcus aureus vaccine (V710): Results of two Phase I studies. Vaccine
CrossRef6
Brad Spellberg, Robert Daum. (2011) Development of a vaccine against Staphylococcus aureus. Seminars in Immunopathology
CrossRef7
Sheila Krishna, Lloyd S. Miller. (2011) Innate and adaptive immune responses against Staphylococcus aureus skin infections. Seminars in Immunopathology
CrossRef8
Richard Proctor. (2011) Is there a future for a Staphylococcus aureus vaccine?. Vaccine
CrossRef9
Hwan Keun Kim, Vilasack Thammavongsa, Olaf Schneewind, Dominique Missiakas. (2011) Recurrent infections and immune evasion strategies of Staphylococcus aureus. Current Opinion in Microbiology
CrossRef10
R. C. Moellering. (2011) MRSA: the first half century. Journal of Antimicrobial Chemotherapy
CrossRef11
Nelianne J Verkaik, Willem JB van Wamel, Alex van Belkum. (2011) Immunotherapeutic approaches against Staphylococcus aureus. Immunotherapy 3:9, 1063-1073
CrossRef12
Barbara M. Bröker, Alex van Belkum. (2011) Immune proteomics of Staphylococcus aureus. PROTEOMICS 11:15, 3221-3231
CrossRef13
Jane Broughan, Richard Anderson, Annaliesa S Anderson. (2011) Strategies for and advances in the development of Staphylococcus aureus prophylactic vaccines. Expert Review of Vaccines 10:5, 695-708
CrossRef14
Lynn N. Fitzgibbons, Darcy L. Puls, Kimberly Mackay, Graeme N. Forrest. (2011) Management of Gram-Positive Coccal Bacteremia and Hemodialysis. American Journal of Kidney Diseases 57:4, 624-640
CrossRef15
Igor Diemberger, Mauro Biffi, Cristian Martignani, Giuseppe Boriani. (2011) From lead management to implanted patient management: indications to lead extraction in pacemaker and cardioverter–defibrillator systems. Expert Review of Medical Devices 8:2, 235-255
CrossRef16
Tanvir Huda, Harish Nair, Evropi Theodoratou, Lina Zgaga, Ali Fattom, Shams El Arifeen, Craig Rubens, Harry Campbell, Igor Rudan. (2011) An evaluation of the emerging vaccines and immunotherapy against staphylococcal pneumonia in children. BMC Public Health 11:Suppl 3, S27
CrossRef17
Ying-Chi Lin, Marnie L Peterson. (2010) New insights into the prevention of staphylococcal infections and toxic shock syndrome. Expert Review of Clinical Pharmacology 3:6, 753-767
CrossRef18
Giuseppe Ippolito, Sebastiano Leone, Francesco N. Lauria, Emanuele Nicastri, Richard P. Wenzel. (2010) Methicillin-resistant Staphylococcus aureus: the superbug. International Journal of Infectious Diseases 14, S7-S11
CrossRef19
Michael S. Bronze, James B. Dale. (2010) Progress in the Development of Effective Vaccines to Prevent Selected Gram-Positive Bacterial Infections. The American Journal of the Medical Sciences 340:3, 218-225
CrossRef20
David Skurnik, Massimo Merighi, Martha Grout, Mihaela Gadjeva, Tomas Maira-Litran, Maria Ericsson, Donald A. Goldmann, Susan S. Huang, Rupak Datta, Jean C. Lee, Gerald B. Pier. (2010) Animal and human antibodies to distinct Staphylococcus aureus antigens mutually neutralize opsonic killing and protection in mice. Journal of Clinical Investigation 120:9, 3220-3233
CrossRef21
Liise-anne Pirofski. (2010) Why antibodies disobey the Hippocratic Oath and end up doing harm: a new clue. Journal of Clinical Investigation 120:9, 3099-3102
CrossRef22
Natasha Atanaskova, Kenneth J. Tomecki. (2010) Innovative Management of Recurrent Furunculosis. Dermatologic Clinics 28:3, 479-487
CrossRef23
G. Jacobsson, P. Colque-Navarro, E. Gustafsson, R. Andersson, R. Möllby. (2010) Antibody responses in patients with invasive Staphylococcus aureus infections. European Journal of Clinical Microbiology & Infectious Diseases 29:6, 715-725
CrossRef24
Bruce Y. Lee, Paul J. Ufberg, Rachel R. Bailey, Ann E. Wiringa, Kenneth J. Smith, Andrew J. Nowalk, Conor Higgins, Angela R. Wateska, Robert R. Muder. (2010) The potential economic value of a Staphylococcus aureus vaccine for neonates. Vaccine 28:29, 4653-4660
CrossRef25
Frank R DeLeo, Michael Otto, Barry N Kreiswirth, Henry F Chambers. (2010) Community-associated meticillin-resistant Staphylococcus aureus. The Lancet 375:9725, 1557-1568
CrossRef26
Sharon J. Peacock. 2010. Staphylococcus. .
CrossRef27
Silva Holtfreter, Julia Kolata, Barbara M. Bröker. (2010) Towards the immune proteome of Staphylococcus aureus – The anti-S. aureus antibody response. International Journal of Medical Microbiology 300:2-3, 176-192
CrossRef28
Sanjai Saxena, Charu Gomber. (2010) Surmounting antimicrobial resistance in the Millennium Superbug: Staphylococcus aureus. Central European Journal of Medicine 5:1, 12-29
CrossRef29
Caroline B Long, Rebecca P Madan, Betsy C Herold. (2010) Diagnosis and management of community-associated MRSA infections in children. Expert Review of Anti-infective Therapy 8:2, 183-195
CrossRef30
C. Buddy Creech, B. Gayle Johnson, Andrew R. Alsentzer, Matthew Hohenboken, Kathryn M. Edwards, Thomas R. Talbot. (2009) Vaccination as infection control: A pilot study to determine the impact of Staphylococcus aureus vaccination on nasal carriage. Vaccine 28:1, 256-260
CrossRef31
Henry F. Chambers, Frank R. DeLeo. (2009) Waves of resistance: Staphylococcus aureus in the antibiotic era. Nature Reviews Microbiology 7:9, 629-641
CrossRef32
Cynthia A. Lucero, Jeffrey Hageman, Elizabeth R. Zell, Sandra Bulens, Joelle Nadle, Susan Petit, Ken Gershman, Susan Ray, Lee H. Harrison, Ruth Lynfield, Ghinwa Dumyati, John M. Townes, William Schaffner, Scott K. Fridkin. (2009) Evaluating the potential public health impact of a Staphylococcus aureus vaccine through use of population-based surveillance for invasive methicillin-resistant S. aureus disease in the United States. Vaccine 27:37, 5061-5068
CrossRef33
Mustafa Zakkar, K.M. John Chan, Emre Amirak, Anna Herrey, Prakash P. Punjabi. (2009) Infective Endocarditis of the Mitral Valve: Optimal Management. Progress in Cardiovascular Diseases 51:6, 472-477
CrossRef34
Barbara Haas, Avery B. Nathens. (2009) Future Diagnostic and Therapeutic Approaches in Surgical Infections. Surgical Clinics of North America 89:2, 539-554
CrossRef35
Adam C. Schaffer, Jean C. Lee. (2009) Staphylococcal Vaccines and Immunotherapies. Infectious Disease Clinics of North America 23:1, 153-171
CrossRef36
Kelly Conner, Alice Wuu, Victoria Maldonado, Brenda L. Bartlett, Stephen K. Tyring. (2009) Vaccines under study: non-HIV vaccines. Dermatologic Therapy 22:2, 168-185
CrossRef37
Michael Otto. (2009) Looking toward basic science for potential drug discovery targets against community-associated MRSA. Medicinal Research Reviewsn/a-n/a
CrossRef38
Pramodini Kale-Pradhan, Leonard B Johnson. (2008) Treatment and recurrence management of staphylococcal infections: community-acquired MRSA. Expert Review of Anti-infective Therapy 6:6, 909-915
CrossRef39
Martin Burkhardt, Clara Sei, Andrew Lees, Jimmy Mond. (2008) A Rapid Opsonic Assay for Measuring Killing of Bioluminescent Staphylococcus epidermidis. Hybridoma 27:6, 487-491
CrossRef40
Todd D. Gleeson. (2008) Prevention and Control of Methicillin-Resistant Staphylococcus aureus. Disease-a-Month 54:12, 801-806
CrossRef41
Adam C. Schaffer, Jean C. Lee. (2008) Vaccination and passive immunisation against Staphylococcus aureus. International Journal of Antimicrobial Agents 32, S71-S78
CrossRef42
Natasha VDV Ratnaraja, Peter M Hawkey. (2008) Current challenges in treating MRSA: what are the options?. Expert Review of Anti-infective Therapy 6:5, 601-618
CrossRef43
Kyle J. Popovich, Bala Hota, Robert A. Weinstein. (2008) Treatment of community-associated methicillin-resistant Staphylococcus aureus. Current Infectious Disease Reports 10:5, 411-420
CrossRef44
Preeti N. Malani, Meenakshi M. Rana, Mousumi Banerjee, Suzanne F. Bradley. (2008) Staphylococcus aureus Bloodstream Infections: The Association Between Age and Mortality and Functional Status. Journal of the American Geriatrics Society 56:8, 1485-1489
CrossRef45
John R Middleton. (2008) Staphylococcus aureus antigens and challenges in vaccine development. Expert Review of Vaccines 7:6, 805-815
CrossRef46
Oguz Resat Sipahi. (2008) Economics of antibiotic resistance. Expert Review of Anti-infective Therapy 6:4, 523-539
CrossRef47
Kyle J. Popovich, Bala Hota. (2008) Treatment and prevention of community-associated methicillin-resistant Staphylococcus aureus skin and soft tissue infections. Dermatologic Therapy 21:3, 167-179
CrossRef48
Susan S. Huang, Daniel J. Diekema, David K. Warren, Gianna Zuccotti, Patricia L. Winokur, Shailesh Tendolkar, Linda Boyken, Rupak Datta, Rebecca M. Jones, Melissa A. Ward, Tanya Aubrey, Andrew B. Onderdonk, Christian Garcia, Richard Platt. (2008) Strain‐Relatedness of Methicillin‐Resistant Staphylococcus aureus Isolates Recovered from Patients with Repeated Infection. Clinical Infectious Diseases 46:8, 1241-1247
CrossRef49
Jane D. Siegel, Emily Rhinehart, Marguerite Jackson, Linda Chiarello. (2007) 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Health Care Settings. American Journal of Infection Control 35:10, S65-S164
CrossRef50
Antoni Juan-Torres, Stephan Harbarth. (2007) Prevention of primary bacteraemia. International Journal of Antimicrobial Agents 30, 80-87
CrossRef51
Mitchell DeJonge, David Burchfield, Barry Bloom, Maria Duenas, Whit Walker, Mark Polak, Elizabeth Jung, Dietra Millard, Robert Schelonka, Fabien Eyal, Amy Morris, Barry Kapik, Destrey Roberson, Karen Kesler, Joe Patti, Seth Hetherington. (2007) Clinical Trial of Safety and Efficacy of IHN-A21 for the Prevention of Nosocomial Staphylococcal Bloodstream Infection in Premature Infants. The Journal of Pediatrics 151:3, 260-265.e1
CrossRef52
Kyle J. Popovich, Bala Hota, Robert A. Weinstein. (2007) Treatment of community-associated methicillin-resistant Staphylococcus aureus. Current Infectious Disease Reports 9:5, 398-407
CrossRef53
Robert N. Foley. (2007) Infections in Patients with Chronic Kidney Disease. Infectious Disease Clinics of North America 21:3, 659-672
CrossRef54
Christof von Eiff, Kimberly L. Taylor, Alexander Mellmann, Ali I. Fattom, Alexander W. Friedrich, Georg Peters, Karsten Becker. (2007) Distribution of capsular and surface polysaccharide serotypes of Staphylococcus aureus. Diagnostic Microbiology and Infectious Disease 58:3, 297-302
CrossRef55
Annalisa Pantosti, Andrea Sanchini, Monica Monaco. (2007) Mechanisms of antibiotic resistance in Staphylococcus aureus. Future Microbiology 2:3, 323-334
CrossRef56
W. Greiner, A. Rasch, D. Köhler, B. Salzberger, G. Fätkenheuer, M. Leidig. (2007) Clinical outcome and costs of nosocomial and community-acquired Staphylococcus aureus bloodstream infection in haemodialysis patients. Clinical Microbiology and Infection 13:3, 264-268
CrossRef57
Emma J Bishop, Benjamin P Howden. (2007) Treatment of Staphylococcus aureus infections: new issues, emerging therapies and future directions. Expert Opinion on Emerging Drugs 12:1, 1-22
CrossRef58
Garyphallia Poulakou, Helen Giamarellou. (2007) Investigational treatments for postoperative surgical site infections. Expert Opinion on Investigational Drugs 16:2, 137-155
CrossRef59
Richard H Drew. (2007) Emerging Options for Treatment of Invasive, Multidrug-Resistant Staphylococcus aureus Infections. Pharmacotherapy 27:2, 227-249
CrossRef60
Jodi A Lindsay. (2007) Prospects for a MRSA vaccine. Future Microbiology 2:1, 1-3
CrossRef61
Helen Giamarellou. (2006) Treatment options for multidrug-resistant bacteria. Expert Review of Anti-infective Therapy 4:4, 601-618
CrossRef62
Sakina B. Naqvi, Allan J. Collins. (2006) Infectious Complications in Chronic Kidney Disease. Advances in Chronic Kidney Disease 13:3, 199-204
CrossRef63
Annamaria T. Kausz, David T. Gilbertson. (2006) Overview of Vaccination in Chronic Kidney Disease. Advances in Chronic Kidney Disease 13:3, 209-214
CrossRef64
Marin H. Kollef. (2006) The Intensive Care Unit as a Research Laboratory: Developing Strategies to Prevent Antimicrobial Resistance. Surgical Infections 7:2, 85-99
CrossRef65
Henry R. Shinefield. (2006) Use of a conjugate polysaccharide vaccine in the prevention of invasive staphylococcal disease: Is an additional vaccine needed or possible?. Vaccine 24, S65-S69
CrossRef66
Orfeas Liangos, Ambreen Gul, Nicolaos E. Madias, Bertrand L. Jaber. (2006) UNRESOLVED ISSUES IN DIALYSIS: Long-Term Management of the Tunneled Venous Catheter. Seminars in Dialysis 19:2, 158-164
CrossRef67
Jérome Aboab, Olivier Nardi, Diane Lipiner, Tarek Sharshar, Djillali Annane. (2006) Emerging drugs for the treatment of sepsis. Expert Opinion on Emerging Drugs 11:1, 7-22
CrossRef68
Jordan L. Cocchiaro, Marisa I. Gomez, Allison Risley, Robert Solinga, Daniel O. Sordelli, Jean C. Lee. (2006) Molecular characterization of the capsule locus from non-typeable Staphylococcus aureus. Molecular Microbiology 59:3, 948-960
CrossRef69
Helen C. Maltezou, Helen Giamarellou. (2006) Community-acquired methicillin-resistant Staphylococcus aureus infections. International Journal of Antimicrobial Agents 27:2, 87-96
CrossRef70
Henry R. Shinefield, Steven Black. (2006) Prospects for Active and Passive Immunization Against Staphylococcus aureus. The Pediatric Infectious Disease Journal 25:2, 167-168
CrossRef71
D. E. Craven, D. S. Shapiro. (2006) Staphylococcus aureus: Times, They Are A-Changin'. Clinical Infectious Diseases 42:2, 179-180
CrossRef72
Rachel C. Orscheln, Henry R. Shinefield, Joseph W. St. Geme. 2006. Staphylococcal Infections. , 513-543.
CrossRef73
Andrej Trampuz, Werner Zimmerli. (2006) Antimicrobial Agents in Orthopaedic Surgery. Drugs 66:8, 1089-1105
CrossRef74
Mark D. DANESE, Robert I. GRIFFITHS, Michelle DYLAN, Hsing-Ting YU, Robert DUBOIS, Allen R. NISSENSON. (2006) Mortality differences among organisms causing septicemia in hemodialysis patients. Hemodialysis International 10:1, 56-62
CrossRef75
Stan Deresinski. (2006) Antistaphylococcal Vaccines and Immunoglobulins. Drugs 66:14, 1797-1806
CrossRef76
Li-Yang Hsu, Limin Wijaya, Ban-Hock Tan. (2005) Management of healthcare-associated methicillin-resistant Staphylococcus aureus. Expert Review of Anti-infective Therapy 3:6, 893-905
CrossRef77
Mara Dinits-Pensy, Graeme N. Forrest, Alan S. Cross, Michael K. Hise. (2005) The Use of Vaccines in Adult Patients With Renal Disease. American Journal of Kidney Diseases 46:6, 997-1011
CrossRef78
Henry R Shinefield, Steven Black. (2005) Prevention of Staphylococcus aureus infections: advances in vaccine development. Expert Review of Vaccines 4:5, 669-676
CrossRef79
Marin H. Kollef, Scott T. Micek. (2005) Strategies to prevent antimicrobial resistance in the intensive care unit. Critical Care Medicine 33:8, 1845-1853
CrossRef80
AREEF ISHANI, ALLAN J COLLINS, CHARLES A HERZOG, ROBERT N FOLEY. (2005) Septicemia, access and cardiovascular disease in dialysis patients: The USRDS Wave 2 Study1. Kidney International 68:1, 311-318
CrossRef81
Bertrand L. Jaber. (2005) Bacterial infections in hemodialysis patients: Pathogenesis and prevention. Kidney International 67:6, 2508-2519
CrossRef82
John J. Engemann, Joelle Y. Friedman, Shelby D. Reed, Robert I. Griffiths, Lynda A. Szczech, Keith S. Kaye, Martin E. Stryjewski, L. Barth Reller, Kevin A. Schulman, G. Ralph Corey, Vance G. Fowler. (2005) Clinical Outcomes and Costs Due to Staphylococcus aureus Bacteremia Among Patients Receiving Long‐Term Hemodialysis • . Infection Control and Hospital Epidemiology 26:6, 534-539
CrossRef83
ANIL K SAXENA, BODH R PANHOTRA. (2005) Prevention of catheter-related bloodstream infections: An appraisal of developments in designing an infection-resistant 'dream dialysis-catheter' (Review Article). Nephrology 10:3, 240-248
CrossRef84
Christopher Jones. (2005) Revised structures for the capsular polysaccharides from Staphylococcus aureus Types 5 and 8, components of novel glycoconjugate vaccines. Carbohydrate Research 340:6, 1097-1106
CrossRef85
P. Heizmann, W. R. Heizmann, R. Hetzer. (2005) MRSA: Resistenzmechanismen, Epidemiologie, Risikofaktoren, Prophylaxe, Therapie. Zeitschrift für Herz-,Thorax- und Gefäßchirurgie 19:2, 78-88
CrossRef86
Jan L. Nouwen, Marien W.J.A. Fieren, Susan Snijders, Henri A. Verbrugh, Alex van Belkum. (2005) Persistent (not intermittent) nasal carriage of Staphylococcus aureus is the determinant of CPD-related infections. Kidney International 67:3, 1084-1092
CrossRef87
S. Deresinski. (2005) Methicillin-Resistant Staphylococcus aureus: An Evolutionary, Epidemiologic, and Therapeutic Odyssey. Clinical Infectious Diseases 40:4, 562-573
CrossRef88
M. Roghmann, K.L. Taylor, A. Gupte, M. Zhan, J.A. Johnson, A. Cross, R. Edelman, A.I. Fattom. (2005) Epidemiology of capsular and surface polysaccharide in Staphylococcus aureus infections complicated by bacteraemia. Journal of Hospital Infection 59:1, 27-32
CrossRef89
Ali Fattom, Steve Fuller, Myra Propst, Scott Winston, Larry Muenz, David He, Robert Naso, Gary Horwith. (2004) Safety and immunogenicity of a booster dose of Staphylococcus aureus types 5 and 8 capsular polysaccharide conjugate vaccine (StaphVAX®) in hemodialysis patients. Vaccine 23:5, 656-663
CrossRef90
JOHN B. ROBBINS, RACHEL SCHNEERSON. (2004) Future Vaccine Development at NICHD. Annals of the New York Academy of Sciences 1038:1, 49-59
CrossRef91
Christian Theilacker, Wolfgang A. Krueger, Andrea Kropec, Johannes Huebner. (2004) Rationale for the development of immunotherapy regimens against enterococcal infections. Vaccine 22, S31-S38
CrossRef92
Thomas J. Neuhaus. (2004) Immunization in children with chronic renal failure: a practical approach. Pediatric Nephrology 19:12, 1334-1339
CrossRef93
Edit Gyimesi, Alexander J. Bankovich, Theodore A. Schuman, Joanna B. Goldberg, Margaret A. Lindorfer, Ronald P. Taylor. (2004) Staphylococcus aureus bound to complement receptor 1 on human erythrocytes by bispecific monoclonal antibodies is phagocytosed by acceptor macrophages. Immunology Letters 95:2, 185-192
CrossRef94
L. F. Muscarella. (2004) Is Gastrointestinal Endoscopy a Risk Factor for Whipple's Disease? • . Infection Control and Hospital Epidemiology 25:6, 453-455
CrossRef95
Joseph M Patti. (2004) Immunotherapeutics for nosocomial infections. Expert Opinion on Investigational Drugs 13:6, 673-679
CrossRef96
Marin H. Kollef. (2004) Prevention of hospital-associated pneumonia and ventilator-associated pneumonia. Critical Care Medicine 32:6, 1396-1405
CrossRef97
D. Coskun, J. Aytac, S. Deveci, E. Sonmez. (2004) Evaluation of Surgical‐Site Infections Following Cardiovascular Surgery • . Infection Control and Hospital Epidemiology 25:6, 451-453
CrossRef98
C. Souvignet, G. Frebourg, L. Baril. (2004) Identifying Patients With Severe Hospital‐Acquired Infections Due to Staphylococcus aureus by Using the Healthcare Cost and Utilization Project (HCUP): Problems and Pitfalls • . Infection Control and Hospital Epidemiology 25:6, 450-451
CrossRef99
Kevin B. Laupland, Daniel B. Gregson, David A. Zygun, Christopher J. Doig, Garth Mortis, Deirdre L. Church. (2004) Severe bloodstream infections: A population-based assessment*. Critical Care Medicine 32:4, 992-997
CrossRef100
Ali I Fattom, Gary Horwith, Steve Fuller, Myra Propst, Robert Naso. (2004) Development of StaphVAX™, a polysaccharide conjugate vaccine against S. aureus infection: from the lab bench to phase III clinical trials. Vaccine 22:7, 880-887
CrossRef101
Tomas Maira-Litran, Andrea Kropec, Donald Goldmann, Gerald B Pier. (2004) Biologic properties and vaccine potential of the staphylococcal poly-N-acetyl glucosamine surface polysaccharide. Vaccine 22:7, 872-879
CrossRef102
Trish M Perl. (2003) Prevention of Staphylococcus aureus infections among surgical patients: Beyond traditional perioperative prophylaxis. Surgery 134:5, S10-S17
CrossRef103
Philippe Moingeon, Jeffrey Almond, Michel de Wilde. (2003) Therapeutic vaccines against infectious diseases. Current Opinion in Microbiology 6:5, 462-471
CrossRef104
Stephen Lockhart. (2003) Conjugate vaccines. Expert Review of Vaccines 2:5, 633-648
CrossRef105
JUSTEN H. PASSWELL, SHAI ASHKENAZI, EFRAT HARLEV, DAN MIRON, REUT RAMON, NAHID FARZAM, LIAT LERNER-GEVA, YONIT LEVI, CHIAYUNG CHU, JOSEPH SHILOACH, JOHN B. ROBBINS, RACHEL SCHNEERSON. (2003) Safety and immunogenicity of Shigella sonnei-CRM9 and Shigella flexneri type 2a-r EPAsucc conjugate vaccines in one- to four-year-old children. The Pediatric Infectious Disease Journal 22:8, 701-706
CrossRef106
Timothy Doulton, Nikhant Sabharwal, Hugh S. Cairns, Silke Schelenz, Susannah Eykyn, Patrick O'Donnell, John Chambers, Conell Austen, David J.A. Goldsmith. (2003) Infective endocarditis in dialysis patients: New challenges and old. Kidney International 64:2, 720-727
CrossRef107
Leon Iri Kupferwasser, Michael R. Yeaman, Cynthia C. Nast, Deborah Kupferwasser, Yan-Qiong Xiong, Marco Palma, Ambrose L. Cheung, Arnold S. Bayer. (2003) Salicylic acid attenuates virulence in endovascular infections by targeting global regulatory pathways in Staphylococcus aureus. Journal of Clinical Investigation 112:2, 222-233
CrossRef108
Robert J Zagursky, Stephen B Olmsted, David P Russell, Joe L Wooters. (2003) Bioinformatics: how it is being used to identify bacterial vaccine candidates. Expert Review of Vaccines 2:3, 417-436
CrossRef109
Barbara E. Menzies. (2003) The role of fibronectin binding proteins in the pathogenesis of Staphylococcus aureus infections. Current Opinion in Infectious Diseases 16:3, 225-229
CrossRef110
William R. Jarvis, Belinda Ostrowsky. (2003) Dinosaurs, Methicillin‐Resistant Staphylococcus aureus , and Infection Control Personnel: Survival Through Translating Science Into Prevention • . Infection Control and Hospital Epidemiology 24:6, 392-396
CrossRef111
John B. Seal, Beatriz Moreira, Cindy D. Bethel, Robert S. Daum. (2003) Antimicrobial Resistance in Staphylococcus aureus at the University of Chicago Hospitals: A 15‐Year Longitudinal Assessment in a Large University‐Based Hospital • . Infection Control and Hospital Epidemiology 24:6, 403-408
CrossRef112
Franklin D. Lowy. (2003) Antimicrobial resistance: the example of Staphylococcus aureus. Journal of Clinical Investigation 111:9, 1265-1273
CrossRef113
Ken Kikuchi. (2003) Genetic basis of neonatal methicillin-resistant Staphylococcus aureus in Japan. Pediatrics International 45:2, 223-229
CrossRef114
Farrin A. Manian. (2003) Vascular and Cardiac Infections in End-Stage Renal Disease. The American Journal of the Medical Sciences 325:4, 243-250
CrossRef115
Elizabeth Hong-Geller, Goutam Gupta. (2003) Therapeutic approaches to superantigen-based diseases: a review. Journal of Molecular Recognition 16:2, 91-101
CrossRef116
G. Ada, D. Isaacs. (2003) Carbohydrate-protein conjugate vaccines. Clinical Microbiology and Infection 9:2, 79-85
CrossRef117
Naomi Balaban, Yael Gov, Arkady Bitler, Johan R Boelaert. (2003) Prevention of Staphylococcus aureus biofilm on dialysis catheters and adherence to human cells. Kidney International 63:1, 340-345
CrossRef118
Haim Shmuely, Silvio Pitlik, Jacob Yahav, Zmira Samra, Leonard Leibovici. (2003) Seven-Year Study of Bacteremia in Hospitalized Patients on Chronic Hemodialysis in a Single Tertiary Hospital. Renal Failure 25:4, 579-588
CrossRef119
Tom Elliott, Tony Washington, Peter Lambert. (2002) Antibody response to Staphylococcal slime and lipoteichoic acid. The Lancet 360:9349, 1977
CrossRef120
Rondall K. Lane, Michael A. Matthay. (2002) Central line infections. Current Opinion in Critical Care 8:5, 441-448
CrossRef121
J. John Weems, Luna B. Beck. (2002) Nasal carriage of Staphylococcus aureus as a risk factor for skin and soft tissue infections. Current Infectious Disease Reports 4:5, 420-425
CrossRef122
Colin A Michie. (2002) Staphylococcal vaccines. Trends in Immunology 23:9, 461-463
CrossRef123
A.G. Jensen. (2002) Importance of focus identification in the treatment of Staphylococcus aureus bacteraemia. Journal of Hospital Infection 52:1, 29-36
CrossRef124
Kathryn Senior. (2002) Vaccine against hospital-acquired Staphylococcus aureus. Drug Discovery Today 7:8, 443-444
CrossRef
