Antimicriobial resistance patterns of colonizing flora on nurses' hands in the neonatal intensive care unit

Cook, Heather A.; Cimiotti, Jeannie P.; Della‐Latta, Phyllis; Saiman, Lisa; Larson, Elaine

doi:10.1016/j.ajic.2006.05.291

Cited by 33 publications

(24 citation statements)

References 29 publications

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“…Two studies from 2007 also describe a high incidence of S. warneri on the hands of NICU nurses (1,5). Both studies note that previous studies have not described the predominance of S. warneri on the hands of hospital personnel.…”

Section: Discussionmentioning

confidence: 71%

Coagulase-Negative Staphylococcal Skin Carriage among Neonatal Intensive Care Unit Personnel: from Population to Infection

Hira¹,

Sluijter²,

Goessens

et al. 2010

J Clin Microbiol

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Coagulase-negative staphylococci (CoNS) are a major cause of sepsis in neonatal intensive care units (NICU) worldwide. Infecting strains of these commensal bacteria may originate from NICU personnel. Therefore, we studied the characteristics of CoNS isolates from NICU personnel and compared them to those of isolates from the general population and from sepsis patients. Furthermore, we studied the epidemiological effect on CoNS carriage of NICU personnel after a period of absence. In our study, we isolated CoNS from the thumbs of NICU personnel every 2 weeks during the summer of 2005 and sampled personnel returning from vacation and a control group from the general population. Furthermore, we collected sepsis isolates from this period. Isolates were tested for antibiotic resistance, mecA and icaA carriage, biofilm production, and genetic relatedness. We found that mecA and icaA carriage as well as penicillin, oxacillin, and gentamicin resistance were significantly more prevalent in CoNS strains from NICU personnel than in community isolates. Similar trends were observed when postvacation strains were compared to prevacation strains. Furthermore, genetic analysis showed that 90% of the blood isolates were closely related to strains found on the hands of NICU personnel. Our findings revealed that CoNS carried by NICU personnel differ from those in the general population. Hospital strains are replaced by community CoNS after a period of absence. NICU personnel are a likely cause for the cross-contamination of virulent CoNS that originate from the NICU to patients.Coagulase-negative staphylococci (CoNS) are the most-frequent cause of late-onset sepsis among newborn infants in neonatal intensive care units (NICU) worldwide. Incidences of up to 66% of late-onset sepsis have been reported (8, 17). The high incidence of these infections is due not only to a high rate of invasive procedures in immunocompromised patients but also to the bacterium's ability to form biofilms (10).The biofilm-forming property of CoNS generally is considered their most important virulence factor. Biofilm formation is mediated by several factors, such as surface proteins and the polysaccharide intercellular adhesin (PIA). PIA is regulated by the ica operon, and the presence of the ica genes has been shown to be a predictor for biofilm formation in Staphylococcus epidermidis (8,9). Furthermore, we previously showed a strong association between the carriage of icaA and mecA, the gene coding for methicillin resistance.Antibiotic resistance in CoNS, especially against ␤-lactam antibiotics, has increased over the years. The mecA gene is present in more than 80% of the CoNS late-onset sepsis isolates (8). The high rate of antibiotic resistance and their biofilm-forming capacities probably enable CoNS to persist in the intensive care environment by giving them a selective advantage over other more-susceptible species.Since CoNS are commensal skin bacteria, it is generally hypothesized that infecting strains originate from NICU personnel. This theory i...

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Section: Discussionmentioning

confidence: 71%

Coagulase-Negative Staphylococcal Skin Carriage among Neonatal Intensive Care Unit Personnel: from Population to Infection

Hira¹,

Sluijter²,

Goessens

et al. 2010

J Clin Microbiol

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“…While only 12% of subjects carried potentially pathogenic flora, few of which were antimicrobial resistant, the majority were colonized with CoNS, which is considered normal skin flora. We performed a previous study in which S aureus, enterococci, and GNB were similarly recovered from 3%, 2%, and 7% of samples from NICU nurses, respectively [4]. In addition, several studies of HCP hand carriage have been performed during outbreaks in efforts to detect a potential point source.…”

Section: Discussionmentioning

confidence: 99%

Multicenter Study of Hand Carriage of Potential Pathogens by Neonatal ICU Healthcare Personnel: Table 1.

et al. 2014

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“…In previous studies conducted, rates of oxacillin resistance among Coagulase-negative Staphylococci from nurses' hands ranged from 26% to 79%. 13,14 CNS, such as S. epidermidis, mainly causes catheterassociated primary bloodstream infections. In ICUs, approximately one-third of all blood culture isolates from patients with nosocomial bloodstream infections were found to be CNS.…”

Section: Discussionmentioning

confidence: 99%

Emerging Drug-Resistant Bacterial Flora on the Hands of Healthcare Workers- A Challenge!

Kalaiselvi¹,

Padmavathi²

2017

jemds

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BACKGROUNDEstimates indicate that hundreds of millions of patients suffer from hospital-acquired infections each year worldwide. Crosstransmission of microorganisms from the hands of Healthcare Workers (HCWs) is considered the main route for spread of nosocomial infections. Hence, the present study was undertaken to detect the microorganisms present on the hands of healthcare workers and to evaluate the antibiotic sensitivity pattern and multi-drug resistance of those isolates.

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Antimicriobial resistance patterns of colonizing flora on nurses' hands in the neonatal intensive care unit

Cited by 33 publications

References 29 publications

Coagulase-Negative Staphylococcal Skin Carriage among Neonatal Intensive Care Unit Personnel: from Population to Infection

Coagulase-Negative Staphylococcal Skin Carriage among Neonatal Intensive Care Unit Personnel: from Population to Infection

Multicenter Study of Hand Carriage of Potential Pathogens by Neonatal ICU Healthcare Personnel: Table 1.

Emerging Drug-Resistant Bacterial Flora on the Hands of Healthcare Workers- A Challenge!

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