Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-30T21:26:47.688Z Has data issue: false hasContentIssue false

Relatedness of Coagulase-Negative Staphylococci Causing Bacteremia in Low-Birthweight Infants

Published online by Cambridge University Press:  02 January 2015

Marilyn A. Kacica
Affiliation:
Departments of Pediatrics and Pathology and Laboratory Medicine, Albany Medical College and Department of Epidemiology, Albany Medical Center Hospital, Albany, New York
Michael J. Horgan
Affiliation:
Departments of Pediatrics and Pathology and Laboratory Medicine, Albany Medical College and Department of Epidemiology, Albany Medical Center Hospital, Albany, New York
Karen E. Preston
Affiliation:
Departments of Pediatrics and Pathology and Laboratory Medicine, Albany Medical College and Department of Epidemiology, Albany Medical Center Hospital, Albany, New York
Martha Lepow
Affiliation:
Departments of Pediatrics and Pathology and Laboratory Medicine, Albany Medical College and Department of Epidemiology, Albany Medical Center Hospital, Albany, New York
Richard A. Venezia*
Affiliation:
Departments of Pediatrics and Pathology and Laboratory Medicine, Albany Medical College and Department of Epidemiology, Albany Medical Center Hospital, Albany, New York
*
Albany Medical Center, Division of Laboratory Medicine, 43 New Scotland Ave., Albany, NY 12208-3478

Abstract

Objective:

To investigate coagulase-negative staphylococcus (CONS) causing bacteremia in a neonatal intensive care unit (NICU).

Design:

A 14-month retrospective review of 47 infants in the NICU with CONS bacteremia was undertaken to determine CONS glycocalyx production, plasmid pattern, total DNA restriction fragment polymorphism, and clinical risk factors.

Results:

The isolates included 32 Staphylococcus epidermidis, six Staphylococcus haemolyticus, four Staphylococcus warneri, four Staphylococcus saprophyticus, and one Staphylococcus hominis. Sixty-five percent of S epidermidis produced glycocalyx; other species did not. Oxacillin resistance (52%) and the antibiograms of the CONS were consistent with other units in the hospital. Five similar CONS plasmid patterns were found among 16 isolates; 31 isolates had unique patterns. Extractions of total DNA from these isolates were digested using HindIII, HaeIII, and BstEII. Those with similar restriction fragment length patterns could not be linked as nosocomially transmitted among infants with bacteremia.

Conclusion:

Our observations suggest that multiple strains of CONS infect infants in the NICU who have similar risk factors. Although current infection control practices limit transmission of a pathogen, they do not prevent CONS bacteremias.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Hall, RT, Hall, SL, Barnes, WG, Izuegbu, J. Rogolsky, M, Zobras, I. Characteristics of coagulase-negative staphylococci from infants with bacteremia. Pediatr Infect Dis J 1987;6:377383.Google Scholar
2.Hall, SJ. Coagulase-negative staphylococcal infections in neonates. Pediatr Infect Dis J 1991;10:5767.Google Scholar
3.Noel, GJ, Edelson, PJ. Staphylococcus epidermidis bacteremia in neonates: further observations and the occurrence of focal infection. Pediatrics 1984;74:832837.CrossRefGoogle ScholarPubMed
4.Freeman, J, Goldmann, DA, Smith, NE, Sidebottom, DG, Epstein, MEPlatt, R. Association of intravenous lipid emulsion and coagulase-negative staphylococcal bacteremia in neonatal intensive care units. N Engl J Med 1990:323:301308.Google Scholar
5.Freeman, J, Epstein, MESmith, NE, Platt, R, Sidebottom, DG, Goldmann, DA. Extra hospital stay and antibiotic usage with nosocomial coagulase-negative staphylococcal bacteremia in two neonatal intensive care unit populations. Am J Dis Child 1990;144:324329.Google ScholarPubMed
6.Martin, MA, Pfaller, MA, Wengel, RP. Coagulase-negative staphylococcal bacteremia: mortality and hospital stay. Ann Intern Med 1989;100:916.Google Scholar
7.Rotbart, HA, Johnson, ZT, Reller, LB. Analysis of enteric coagulase-negative staphylococci from neonates with necrotizing enterocolitis. Pediatr Infect Dis J 1989;8:140142.Google Scholar
8.Gruskay, J, Harris, MC, Costarino, AT, Polin, RA, Baumgart, S. Neonatal Staphylococcus epidermidis meningitis with unremarkable CSF examination results. Am J Dis Child 1989;143:580582.Google Scholar
9.Schwartz, C, Henrickson, KJ, Roghmann, K, Powell, K. Prevention of bacteremia attributed to luminal colonization of tunneled central venous catheters with vancomycin-susceptible organisms. J Clin Oncol 1990;8:15911597.CrossRefGoogle ScholarPubMed
10.Peters, G, Pulverer, G. Pathogenesis and management of Staphylococcus epidermidis “plastic” foreign body infections. J Antimicrob Chemother 1984;14 (suppl D) :6771.CrossRefGoogle ScholarPubMed
11.Kingston, D, Seal, LW, Hill, ID. Self-disinfecting plastics for intravenous catheters and prosthetic inserts. J Hyg Lond 1986;96:185198.Google Scholar
12.Patrick, CC. Coagulase-negative staphylococci: pathogens with increasing clinical significance. J Pediatr 1990;116:497507.CrossRefGoogle ScholarPubMed
13.Christensen, GD, Parisi, JT, Bisno, AL, Simpson, WA, Beachey, EH. Characterization of clinically significant strains of coagulase-negative staphylococci. J Clin Microbiol 1983;18:258269.Google Scholar
14.Parisi, JT, Hecht, DW. Plasmid profiles in epidemiologic studies of infections by Staphylococcus epidermidis. J Infect Dis 1980;141:637643.Google Scholar
15.Valvano, MA, Hat-stein, AI, Morthland, VH, et al. Plasmid DNA analysis of Staphylococcus epidermidis isolated from blood and colonization cultures in very low birth weight neonates. Pediatr Infect Dis J 1988;7:116120.Google Scholar
16.Fidalgo, S, Vazguez, F, Mendoza, MC, Perez, F, Mendez, FJ. Bacteremia due to Staphylococcus epidermidis: microbiologic, epidemiologic, clinical, and prognostic features. Rev infect Dis 1990;12:520528.Google Scholar
17.Herwaldt, LA, Hollis, RJ, Boyken, LD, Pfaller, MA. Molecular epidemiology of coagulase-negative staphylococci isolated from immunocompromised patients. Infect Control Hosp Epidemiol 1992;13:8692.Google Scholar
18.National Committee for Clinical Laboratory Standards (NCCLS). Performance Standards for Antimicrobial Disk Susceptibility Testing. M2-A4.1990;10:128.Google Scholar
19.Bialkowska-Hobrzanska, H, Jaskot, D, Hammergerg, O. Evaluation of restriction endonuclease finger-printing of chromosomal DNA and plasmid profile analysis for characterization of multiresistant coagulase-negative staphylococci in bacteremic neonates. J Clin Microbiol 1990;28:269275.CrossRefGoogle Scholar
20.Ausubel, FM, Brent, R, Kingston, RE, et al, eds. Current Protocols in Molecular Biology. New York, NY:John Wiley and Sons; 1987: 10.Google Scholar
21.Christensen, GD, Simpson, WA, Younger, JJ, et al. Adherence of coagulase-negative staphylococci to plastic tissue culture plates: a quantitative model for the adherence of staphylococci to medical devices. J Clin Microbiol 1985;22:9961006.Google Scholar
22.Fleer, A, Verhoef, J, Hernandez, AP. Coagulase-negative staphylococci as nosocomial pathogens in neonates. Am J Med 1986;(suppl 6B):161165.Google Scholar
23.D’Angio, CT, McGowan, KL, Baumgart, S, St Gerne, J, Harris, MC. Surface colonization with coagulase-negative staphylococci in premature neonates. J Pediatr 1989;114:10291034.CrossRefGoogle ScholarPubMed
24.Patrick, CH, John, JF, Levkcoff, AH, Atkins, LM. Relatedness of strains of methicillin-resistant coagulase-negative Staphylococcus colonizing hospital personnel and producing bacteremias in neonatal intensive care units. Pediatr Infect Dis J 1992;11:935940.CrossRefGoogle Scholar