Molecular epidemiology of coagulase-negative Staphylococcus carriage in neonates admitted to an intensive care unit in Brazil
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2013
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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.
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mecA, Coagulase-negative Staphylococcus, Neonates, SCCmec, Neonatal intensive care units
Citação
TERNES, Yves Mauro et. al. Molecular epidemiology of coagulase-negative Staphylococcus carriage in neonates admitted to an intensive care unit in Brazil. BMC Infectious Diseases, London, v. 13, n. 572, 2013.