Alteration of the colonization pattern of coagulase-negative staphylococci in patients undergoing treatment for hematological malignancy

Ahlstrand, Erik; Persson, Lars-Göran; Tidefelt, Ulf; Söderquist, Bo

doi:10.1007/s10096-011-1493-6

Cited by 9 publications

(4 citation statements)

References 31 publications

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“…But even use of enrichment broth techniques did not enable us to detect the presence of MRSE at admission to the ICU in seven of the nine community patients, implying that six of these seven subjects were subsequently colonized with HA-MRSE within 3 days of hospitalization by cross-contamination from the hospital environment or HCWs. Corroborating our results, prolonged hospitalization have been correlated with both the emergence of HA-MRSE and decreased clonal diversity [25, 26]. Minimizing length of stay prior to surgery may be one factor to consider in reducing colonization of HA-MRSE in patients.…”

Section: Discussionsupporting

confidence: 73%

Colonization of patients, healthcare workers, and the environment with healthcare-associated Staphylococcus epidermidis genotypes in an intensive care unit: a prospective observational cohort study

et al. 2016

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BackgroundDuring the last decades, healthcare-associated genotypes of methicillin-resistant Staphylococcus epidermidis (HA-MRSE) have been established as important opportunistic pathogens. However, data on potential reservoirs on HA-MRSE is limited. The aim of the present study was to investigate the dynamics and to which extent HA-MRSE genotypes colonize patients, healthcare workers (HCWs) and the environment in an intensive care unit (ICU).MethodsOver 12 months in 2006–2007, swab samples were obtained from patients admitted directly from the community to the ICU and patients transferred from a referral hospital, as well as from HCWs, and the ICU environment. Patients were sampled every third day during hospitalization. Antibiotic susceptibility testing was performed according to EUCAST guidelines. Pulsed-field gel electrophoresis and multilocus sequence typing were used to determine the genetic relatedness of a subset of MRSE isolates.ResultsWe identified 620 MRSE isolates from 570 cultures obtained from 37 HCWs, 14 patients, and 14 environmental surfaces in the ICU. HA-MRSE genotypes were identified at admission in only one of the nine patients admitted directly from the community, of which the majority subsequently were colonized by HA-MRSE genotypes within 3 days during hospitalization. Almost all (89%) of HCWs were nasal carriers of HA-MRSE genotypes. Similarly, a significant proportion of patients transferred from the referral hospital and fomites in the ICU were widely colonized with HA-MRSE genotypes.ConclusionsPatients transferred from a referral hospital, HCWs, and the hospital environment serve as important reservoirs for HA-MRSE. These observations highlight the need for implementation of effective infection prevention and control measures aiming at reducing HA-MRSE transmission in the healthcare setting.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-2094-x) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 73%

Colonization of patients, healthcare workers, and the environment with healthcare-associated Staphylococcus epidermidis genotypes in an intensive care unit: a prospective observational cohort study

et al. 2016

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“…In particular, the immune state of the host or underlying disease, as well as contact with the hospital environment, have been shown to enhance antibiotic resistant bacteria in the nasal flora, often leading to decreased biodiversity. 1,20 On the other hand, both in inpatients and healthy persons, S. aureus colonization appears to be negatively correlated with the abundance of S. epidermidis and Corynebacterium, 20,37 which in the case of S. epidermidis appears to be a result of agr-dependent cross-inhibition. 37 Rates of nasal colonization with methicillin resistant isolates are usually lower in the community and tend to increase in the hospital environment, and are much higher among CoNS than among S. aureus.…”

Section: Introductionmentioning

confidence: 89%

Nasal Carriage of Methicillin Resistant Staphylococci

Faria

Conceição

Miragaia

et al. 2014

Microbial Drug Resistance

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Coagulase-negative staphylococci (CoNS) are believed to function as reservoirs, as well as possible sources of staphylococcal chromosome cassette mec (SCCmec) to Staphylococcus aureus, but the frequency, preferred partners, and factors promoting SCCmec transfer are not known. Such postulated in vivo genetic transfer events are likely to occur at anatomical sites such as the normal nasal mucosa, which is known to be colonized by both CoNS and coagulase positive staphylococci. In this study, we characterized S. aureus and CoNS strains colonizing the anterior nares of 67 patients in Denmark. A total of 54 patients (80%) were colonized with staphylococci that included nine different species identified by internal transcribed spacer PCR (ITS-PCR) and 16S RNA sequencing. The highest rates of colonization were found for S. epidermidis (58%) and S. aureus (39%). Methicillin resistance was present in S. aureus (53%), S. epidermidis (53%), S. haemolyticus (33%), and S. hominis (62%). Genetic backgrounds were characterized by spa typing for S. aureus and by pulsed-field gel electrophoresis for CoNS. SCCmec typing showed that SCCmec type IV (2B) was the most common in the entire collection (65%). Carriage of multiple species was detected in 20 patients (30%), 16 of whom were colonized with both S. aureus and S. epidermidis. In two cases, simultaneous carriage of different methicillin resistant species was detected. However, the strains carried different SCCmec types. Additional studies in the same epidemiological settings are warranted to identify interspecific genetic events that involve the acquisition of SCCmec by S. aureus.

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“…Coagulase-negative staphylococci (CoNS) are the most abundant common microbial species of the human skin and mucous membranes, and they are one of the major health care-associated opportunistic pathogens [1, 2]. CoNS can easily attach and grow on the surface of medical devices through a slime layer that has a muco-polysaccharide structure [3–5].…”

Section: Introductionmentioning

confidence: 99%

The species distribution, antimicrobial resistance and risk factors for poor outcome of coagulase-negative staphylococci bacteraemia in China

Cui

Liang

et al. 2019

Antimicrob Resist Infect Control

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Objective Coagulase-negative staphylococci (CoNS) are one of the major opportunistic pathogens and the incidence of CoNS bacteraemia is increasing. However, most of the CoNS-positive blood cultures are contaminants rather than true CoNS bacteraemia. In order to minimize contamination, we defined true CoNS bacteraemia as the patient that has two or more identical CoNS-positive blood cultures drawn within 48 h in this study and the objective of this study was to analyse the species distribution and antibiotic resistance and to identify risk factors for 30-day mortality of the true CoNS-bacteraemia. Method By reviewing the electronic medical database, this study retrospectively analysed patients diagnosed as CoNS bacteraemia by blood cultures in a comprehensive tertiary care hospital in China from January 1, 2014, to December 31, 2017. Result A total of 1241 patients with 1562 episodes of CoNS-positive blood cultures were recorded in the database but only 157 patients were finally diagnosed as true CoNS bacteraemia after contaminants were excluded. All these 157 patients (12.7%, 157/1241) had bacteraemia-related clinical symptoms. Among the 157 patients, the most common species were Staphylococcus hominis (40.8%), Staphylococcus epidermidis (36.3%) and Staphylococcus capitis (11.5%). The antimicrobial susceptibility tests showed that all CoNS had a high rate of resistance to penicillin (94.9%), oxacillin (93.6%) and erythromycin (92.4%). Resistance to gentamicin (22.3%) and rifampicin (10.8%) was low, and none of the bacteria were resistant to vancomycin or linezolid. The 30-day mortality of patients with CoNS bacteraemia was up to 12.7% (20/157), and the multivariate logistics regression analysis showed that chronic renal failure (OR 5.9, 95% CI 1.6–21.5, p = 0.007) and chronic liver failure (OR 4.0, 95% CI 1.2–13.1, p = 0.024) were both the significant independent risk factors for the 30-day mortality of CoNS bacteraemia. Conclusion Staphylococcus hominis and Staphylococcus epidermidis were the most common species in CoNS bacteraemia. All CoNS had high multi-drug resistance, but gentamicin and rifampicin had a relatively lower resistance and could be considered as alternative antibiotics for anti-CoNS bacteraemia in addition to vancomycin and linezolid. Additionally, patients with chronic renal failure or chronic liver failure have a higher 30-day mortality after the onset of CoNS bacteraemia.

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Alteration of the colonization pattern of coagulase-negative staphylococci in patients undergoing treatment for hematological malignancy

Cited by 9 publications

References 31 publications

Colonization of patients, healthcare workers, and the environment with healthcare-associated Staphylococcus epidermidis genotypes in an intensive care unit: a prospective observational cohort study

Colonization of patients, healthcare workers, and the environment with healthcare-associated Staphylococcus epidermidis genotypes in an intensive care unit: a prospective observational cohort study

Nasal Carriage of Methicillin Resistant Staphylococci

The species distribution, antimicrobial resistance and risk factors for poor outcome of coagulase-negative staphylococci bacteraemia in China

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