Colonization with coagulase-negative staphylococci in two neonatal units

• Published in: The Journal of hospital infection Vol. 22; no. 4; pp. 287 - 298
• Main Authors: Nyström, B., Ransjö, U., Ringertz, S., Faxelius, G., Tunell, R., Öhman, G., Wilton, J., Pfaller, M.A.
• Format: Journal Article
• Language: English
• Published: Kent Elsevier Ltd 01.12.1992; Elsevier
• Subjects: Anti-Bacterial Agents - pharmacology; Antibiotic usage; Bacterial diseases; Bacterial sepsis; Biological and medical sciences; Coagulase; coagulase-negative staphylococci; colonization; Colony Count, Microbial; Drug Resistance, Microbial - genetics; Drug Utilization; Hospitals, Teaching - statistics & numerical data; Human bacterial diseases; Humans; Infant, Newborn - microbiology; Infectious diseases; Intensive Care Units, Neonatal - statistics & numerical data; Medical sciences; Microbial Sensitivity Tests; neonates; Nurseries, Hospital - statistics & numerical data; Staphylococcal infections, streptococcal infections, pneumococcal infections; Staphylococcus - genetics; Staphylococcus - growth & development; Staphylococcus epidermidis; Staphylococcus haemolyticus; Sweden - epidemiology; Sweden; Europe; neonates; Antibiotic usage; colonization; coagulase-negative staphylococci; Human; Drug susceptibility test; Septicemia; Chloramphenicol; Erythromycin; Epidemiology; Antimicrobial agent; Infection; Resistance; Antibiotic; Newborn; Bacteriosis; Staphylococcal infection; Colonization
• ISSN: 0195-6701; 1532-2939
• DOI: 10.1016/0195-6701(92)90014-D

Episodes of septicaemia due to coagulase-negative staphylococci (CNS) were more frequent in a level III than in a level II neonatal unit in Stockholm, Sweden. Colonization with CNS during the first 2 weeks of life was investigated in 10 infants from each unit. As the use of antibiotics differed between the two units, the aim was to correlate colonization and antimicrobial resistance patterns to antibiotic usage. Antimicrobial susceptibility of CNS to isoxazolylpenicillins, co-trimoxazole, erythromycin, clindamycin, chloramphenicol and gentamicin was determined. Selected isolates were typed with restriction endonuclease analysis of plasmid DNA and of genomic DNA. Infants were frequently colonized with multiple strains and species of CNS, and transmission of strains from patient to patient occurred within the unit. Qualitative and quantitative differences in antibiotic use were not correlated with colonization. The prevalence of resistant isolates, mostly of Staphylococcus haemolyticus, was higher in the level II unit with lower use of antibiotics. Staphylococcus epidermidis, which is generally more virulent, prevailed in the level III unit, where there were more severely ill children and invasive procedures were more frequently performed.