Molecular epidemiology of coagulase-negative Staphylococcus carriage in neonates admitted to an intensive care unit in Brazil

BMC Infectious Diseases

André Kipnis¹  Ana Lúcia Andrade¹  Ruth Minamisava⁴  Maria Aparecida da Silva Vieira²  Vicente Porfírio Pessoa³  Maria Cláudia Porfirio André¹  Juliana Lamaro-Cardoso¹  Yves Mauro Ternes¹ 

[1] Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, GO, Brazil;Pontifical Catholic University of Goiás, Goiânia, GO, Brazil;Children’s Hospital, Goiânia, Brazil;School of Nursing, Federal University of Goiás, Goiânia, GO, Brazil

关键词: Neonates;    Neonatal intensive care units;    SCCmec;    mecA;    Coagulase-negative Staphylococcus;   

Others  :  1145343
DOI  :  10.1186/1471-2334-13-572

 received in 2013-06-02, accepted in 2013-11-26,  发布年份 2013

【 摘 要 】

Background

Nasal colonization with coagulase-negative Staphylococcus (CoNS) has been described as a risk factor for subsequent systemic infection. In this study, we evaluated the genetic profile of CoNS isolates colonizing the nares of children admitted to a neonatal intensive care unit (NICU).

Methods

We assessed CoNS carriage at admittance and discharge among newborns admitted to a NICU from July 2007 through May 2008 in one of the major municipalities of Brazil. Isolates were screened on mannitol salt agar and tryptic soy broth and tested for susceptibility to antimicrobials using the disc diffusion method. Polymerase chain reaction (PCR) was used to determine the species, the presence of the mecA gene, and to perform SCCmec typing. S. epidermidis and S. haemolyticus isolated from the same child at both admission and discharge were characterized by PFGE.

Results

Among 429 neonates admitted to the NICU, 392 (91.4%) had nasal swabs collected at both admission and discharge. The incidence of CoNS during the hospitalization period was 55.9% (95% confidence interval [CI]: 50.9-60.7). The most frequently isolated species were S. haemolyticus (38.3%) and S.epidermidis (38.0%). Multidrug resistance (MDR) was detected in 2.2% and 29.9% of the CoNS isolates, respectively at admittance and discharge (p = 0.053). The mecA gene was more prevalent among strains isolated at discharge (83.6%) than those isolated at admission (60%); overall, SCCmec type I was isolated most frequently. The length of hospitalization was associated with colonization by MDR isolates (p < 0.005). Great genetic diversity was observed among S. epidermidis and S. haemolyticus.

Conclusions

NICU represents an environment of risk for colonization by MDR CoNS. Neonates admitted to the NICU can become a reservoir of CoNS strains with the potential to spread MDR strains into the community.

【 授权许可】

   
2013 Ternes et al.; licensee BioMed Central Ltd.

【 图 表 】

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