Genotypic study documents divergence in the pathogenesis of bloodstream infection related central venous catheters in neonates

Brito, Cristiane Silveira de; Ribas, Rosineide Marques; Resende, Daiane Silva; Brito, Denise Von Dolinger de; Abdallah, Vânia Olivetti Steffen; Santos, Kátia Regina Netto dos; Cavalcante, Fátima Gonçalves; Matos, Pricilla D.M.; Filho, Paulo Pinto Gontijo

doi:10.1016/j.bjid.2013.11.010

Cited by 9 publications

(11 citation statements)

References 31 publications

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“…Our results which showed that S . epidermidis constituted 81.7% of CoNS species is consistent with this notion and was similar to the results of previous studies in Norway [ 15 ], Brazil [ 38 ] and Turkey [ 39 ] where S . epidermidis was reported as the most common CoNS species associated with neonatal bloodstream infections.…”

Section: Discussionsupporting

confidence: 93%

Antimicrobial resistance and virulence determinants in coagulase-negative staphylococci isolated mainly from preterm neonates

Al-Haqan¹,

Boswihi²,

Pathan³

et al. 2020

PLoS ONE

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Coagulase-negative staphylococci (CoNS) are the most common isolates from blood culture in neonates resulting in high mortality and morbidity. This study investigated CoNS obtained from blood cultures of neonates for antibiotic resistance and virulence factors, and possible association with inflammatory response (C-reactive protein). A total of 93 CoNS isolates were collected from 76 blood cultures of neonates at the Maternity hospital in Kuwait in a six-month period and investigated for susceptibility to antibiotics, carriage of staphylococcal cassette chromosome mec (SCC mec ), and virulence-associated genes. The 93 CoNS isolates consisted of S . epidermidis (76; 81.7%), S . capitis (12; 12.9%), S . hominis (2; 2.1%), S . warneri (2; 2.1%) and S . haemolyticus (1; 1.0%). Eighty-six (92.4%) of the isolates were resistant to cefoxitin (MR-CoNS) while 49 (52.7%) expressed multi-antibiotic resistance. The methicillin-resistant isolates (MR-CoNS) carried SCC mec III, SCC mec IVa and four combinations of SCC mec types including SCC mec types I+IVa (one S . warneri and 25 S . epidermidis isolates), types I+III (one S . epidermidis isolate), types III+IVa (six S . epidermidis isolates) and types I+III+IVa (one S . epidermidis isolate). The most common virulence-related genes were icaC , seb , arc detected in 69.7%, 60.5%, 40.8% of the isolates respectively. Two isolates were positive for tst1 . No association between C-reactive protein and antibiotic resistance or virulence factors was established. This study revealed that S . epidermidis carrying different SCC mec genetic elements, was the dominant CoNS species isolated from neonatal blood cultures with 90.3% and 36.6% of the isolates positive for genes for biofilm and ACME production respectively.

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Section: Discussionsupporting

confidence: 93%

Antimicrobial resistance and virulence determinants in coagulase-negative staphylococci isolated mainly from preterm neonates

Al-Haqan¹,

Boswihi²,

Pathan³

et al. 2020

PLoS ONE

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“…Tests were performed to determine the limit of detection of PCR using serial dilutions of genomic DNA, extracted from 10 3 colony-forming units per milliliter (CFU/ml) culture aliquots, plated on brain heart infusion (BHI) agar plates, to reproduce the minimum detectable level of CFUs 9 . In order to determine the sensitivity of the primer to lower DNA concentrations extracted from 10 3 CFU/ml, serial dilutions were prepared, and PCR was performed on the titrations using the same bacterial detection parameters.…”

mentioning

confidence: 99%

Comparison of five methods of extraction of Staphylococcus aureus DNA for molecular detection by PCR

Lara

Lucas

Kalapothakis

et al. 2018

Rev. Soc. Bras. Med. Trop.

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“…Bloodstream infection (BSI) remains the most frequent adverse event among premature infants worldwide, associated with increased hospital stay length and costs, poor outcomes, and even death. 1,2 The association of these infections with the use of central venous catheters (CVCs) in newborns ranges from 17.3/1,000 CVC-day in neonates weighing from 1,501 g to 2,500 g to 34.9/ 1,000 CVC-day in neonates <1,000 g. 3 Although the pathogenesis of catheter-related bloodstream infections (CR-BSIs) is multifactorial and complex, references from studies in adults indicate two main potential routes of contamination of the catheter tip: (1) extraluminal, that is, organisms present in patient skin at the insertion site can migrate into the catheter tract, resulting in colonization of the catheter tip-regarding short-term catheters, this is the most common source of infection; 4,5 and, (2) intraluminal, that is, after the first week of placement, intraluminal contamination and colonization after hub manipulation occurs, which is responsible for most CR-BSI. 6,7 In premature neonates, microbial translocation through the colonized mucosa is an underestimated source of infection that requires investigation.…”

Section: Introductionmentioning

confidence: 99%

Origin of Catheter-Related Bloodstream Infections Caused by Staphylococcus epidermidis in Critical Neonates

Resende

Queiroz

Araújo

et al. 2020

Journal of Child Science

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Bloodstream infection (BSI) remains the most frequent adverse event among premature infants worldwide, associated with increased hospital stay length and costs, poor outcomes, and even death. The aim of this study was to investigate the origin of catheter-related bloodstream infections (CR-BSIs) by Staphylococcus epidermidis in critical neonates, using molecular biology techniques. This was an observational study comprising neonates presenting BSI using central venous catheters (CVCs) for over 24 hours. Skin cultures obtained from the catheter insertion site, CVC hub, and neonate nasal and intestinal mucosa, were performed weekly from 48 hours from the beginning of the invasive procedure, as well as from the tip of the CVC after its withdrawal. Quantitative cultures were also performed of the tip with modifications and the “roll-plate” technique. Isolates identification were obtained using a VITEK II automated system. Molecular subtyping by pulsed-field gel electrophoresis (PFGE) was used to determine the origin of all BSIs. Among 19 primary BSI caused by S. epidermidis, BSI origin was defined in only 21.1% of the cases, where one was characterized as definite intraluminal, two as definite extraluminal, and one as translocation. Origin was indeterminate in 78.9% of the cases analyzed by PFGE. A total of 27 different genotype profiles were obtained. The spread of a prevalent clone in the unit (clone A) was detected in 28.6% of the samples. Most BSIs related to catheter caused by S. epidermidis were not able to prove the origin of most microorganisms present in neonate blood, demonstrating the difficulty in determining it in this population of patients. The lack of a better explanation of the origin of CR-BSI in neonates limits the direction of specific intervention measures.

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Genotypic study documents divergence in the pathogenesis of bloodstream infection related central venous catheters in neonates

Abstract: The majority of infections caused by S. epidermidis in neonates had an unknown origin, although 33.3% appeared to have been acquired intraluminally and extraluminally. We observed a polyclonal profile between sensitive samples and a prevalent clone (A) between resistant samples.

Cited by 9 publications

References 31 publications

Antimicrobial resistance and virulence determinants in coagulase-negative staphylococci isolated mainly from preterm neonates

Antimicrobial resistance and virulence determinants in coagulase-negative staphylococci isolated mainly from preterm neonates

Comparison of five methods of extraction of Staphylococcus aureus DNA for molecular detection by PCR

Origin of Catheter-Related Bloodstream Infections Caused by Staphylococcus epidermidis in Critical Neonates

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