Association of mannose-binding lectin 2 gene polymorphisms with persistent Staphylococcus aureus bacteremia

Area of Science:

• Immunology
• Genetics
• Infectious Diseases

Background:

• Mannose-binding lectin (MBL) is crucial for innate immunity.
• MBL2 gene variations can lead to reduced MBL levels, increasing susceptibility to infections.
• Persistent Staphylococcus aureus bacteremia (SAB) poses a significant clinical challenge.

Purpose of the Study:

• To investigate the association between serum MBL levels and MBL2 polymorphisms with persistent SAB in adult Korean patients.
• To determine if MBL levels and MBL2 genotypes are risk factors for persistent SAB.

Main Methods:

• A case-control study nested within a prospective SAB cohort.
• Genotyping of six MBL2 single-nucleotide polymorphisms (promoter and exon 1 regions).
• Measurement of serum MBL concentrations and comparison between persistent SAB, resolving SAB, and healthy individuals.

Main Results:

• Patients with persistent SAB had significantly lower MBL levels and MBL2 genotypes associated with low MBL production compared to those with resolving SAB.
• Low/deficient MBL-producing genotypes were independently associated with persistent SAB (aOR, 7.64).
• MBL2 genotypes linked to low MBL were more prevalent in persistent SAB patients than in healthy controls (OR, 2.09).

Conclusions:

• This study provides the first evidence linking low MBL levels and MBL2 polymorphisms to persistent SAB.
• Persistent SAB development is likely multifactorial, involving clinical, microbiological, and host defense factors like MBL.
• MBL levels and MBL2 genotype represent potential host defense factors influencing SAB outcomes.