Microbiologic studies of coagulase-negative staphylococci isolated from patients with nosocomial bacteraemias

León, Samuel Ponce de; Guenthner, Sharon H.; Wenzel, Richard P.

doi:10.1016/0195-6701(86)90054-x

Cited by 25 publications

(12 citation statements)

References 24 publications

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“…Under laboratory conditions, variants of S. epidermidis RP62A with diminished slime production became susceptible to oxacillin, penicillin, and ampicillin, suggesting a direct association between slime and resistance (4). This is not always the case, however (37,38), and it is also possible that biofilm production and antibiotic resistance have been independently selected as determinants that confer a selective advantage for colonization and survival in the NICU environment.…”

Section: Discussionmentioning

confidence: 93%

“…epidermidis is the most common cause of nosocomial infections in neonates, and putative virulence determinants have been studied most intensively for this species of CoNS. However, slime production has been reported for S. hominis and S. haemolyticus (5,22,29,38,43), S. warneri (22), S. saprophyticus (12,29), and S. simulans (12). Cross-species hybridization with DNA blots and simultaneous probes for S. epidermidis and S. aureus icaA has also been demonstrated for S. auricularis and S. capitis but not S. haemolyticus, S. hominis, or S. warneri (8).…”

Section: Discussionmentioning

confidence: 99%

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The ica Operon and Biofilm Production in Coagulase-Negative Staphylococci Associated with Carriage and Disease in a Neonatal Intensive Care Unit

et al. 2002

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Coagulase-negative staphylococci (CoNS) are a major cause of sepsis in the neonatal intensive care unit (NICU). We evaluated the hypothesis that the ica operon and biofilm production are associated with CoNS disease in this setting. CoNS associated with bacteremia or blood culture contamination and from the skin of infants with CoNS bacteremia or healthy controls were obtained during a prospective case-control study on a busy NICU. A total of 180 strains were identified, of which 122 (68%) were Staphylococcus epidermidis and the remainder were S. capitis (n ‫؍‬ 29), S. haemolyticus (n ‫؍‬ 11), S. hominis (n ‫؍‬ 9), S. warneri (n ‫؍‬ 8), and S. auricularis (n ‫؍‬ 1). The presence of the genes icaA, icaB, icaC, and icaD was determined by PCR, and biofilm production was examined using qualitative (Congo red agar [CRA]) and quantitative (microtiter plate) techniques. There were no significant differences in the presence of the ica operon or CRA positivity among the four groups of strains. However, quantitative biofilm production was significantly greater in strains isolated from either the blood or the skin of neonates with S. epidermidis bacteremia. We conclude that the quantity of biofilm produced may be associated with the ability to cause CoNS infection. This conclusion suggests that the regulation of biofilm expression may play a central role in the disease process.Coagulase-negative staphylococci (CoNS) are the major cause of late-onset sepsis in preterm infants (27,39,42,44). Approximately one in six very-low-birth-weight (Ͻ1,500-g) neonates develops an episode of CoNS bacteremia (21, 44), an event that is associated with a significant increase in morbidity and mortality (44), duration of hospital stay (18,21,44), and overall cost of treatment (44). There is thus a need to reduce the risk of sepsis in this setting, a goal which depends in part on defining the pathogenesis of infection.The role of biofilm formation as a determinant of CoNS infection has been the subject of ongoing study since the observation that some isolates of Staphylococcus epidermidis produced mucoid growth in vitro that adhered to the walls of culture tubes (2). A series of studies subsequently reported that this material, termed slime, was more commonly produced by isolates associated with sepsis, including intravenous-catheter-related bacteremia and other prosthetic device infections (5,6,10,14,28,31). The relevance to the neonatal intensive care unit (NICU) setting of slime production by CoNS isolates has been studied in relation to both carriage flora and isolates causing infection. The proportion of slime-producing CoNS in carriage flora increased on repeated sampling of neonates during the first 4 weeks of age in one unit (9) but did not vary in two other units over either 2 weeks (35) or a mean of 8 weeks (24). Endemic clones of CoNS that were associated with disease and that were slime producers were demonstrated to persist over a period of 10 years in one unit (26); however, carriage flora was not examined, and an association be...

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

The ica Operon and Biofilm Production in Coagulase-Negative Staphylococci Associated with Carriage and Disease in a Neonatal Intensive Care Unit

et al. 2002

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“…This species has been frequently isolated from blood cultures, although it has been considered to be clinically significant in only a small proportion of cases (Bowman & Buck, 1984;Pulverer, 1985;Ponce de Leon et al, 1986;Kleeman et al, 1993). During the past six years, an increasing proportion of blood culture isolates of S. hominis have been identified as aberrant strains of this species or misidentified as Staphylococcus equorurn (Tural et al, 1995 ;Weinstein et al, 1995).…”

Section: Introductionmentioning

confidence: 99%

Staphylococcus hominis subsp. novobiosepticus subsp. nov., a novel trehalose- and N-acetyl-D-glucosamine-negative, novobiocin- and multiple-antibiotic-resistant subspecies isolated from human blood cultures

Kloos

George

Olgiate

et al. 1998

International Journal of Systematic Bacteriology

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A new subspecies, Staphylococcus horninis subsp. novobiosepticus, isolated from human blood cultures, a wound, a breast abscess and a catheter tip, is described on the basis of a study of 26 strains isolated between 1989 and 1996.DNA-DNA reassociation reactions, conducted under stringent conditions, and macrorestriction pattern analysis demonstrated that these strains are closely related to previously characterized 5. horninis strains isolated from human skin and clinical specimens, but are significantly divergent. 5. horninis subsp. novobiosepticus can be distinguished from 5. horninis (now named 5. horninis subsp. horninis) by its combined characteristics of novobiocin resistance and failure to produce acid aerobically from D-trehalose and N-aCety1-Dglucosamine. Furthermore, all 26 strains of the new subspecies are resistant to nalidixic acid, penicillin G, oxacillin, kanamycin and streptomycin, and were either resistant or had intermediate resistance to methicillin and gentamicin. Most strains were also resistant to erythromycin, clindamycin, chloramphenicol, trimethoprim/sulfamethoxazole and ciprof loxacin. Based on a comparison of the sequences of a 1001 bp rned amplification product from reference methicillin-resistant staphylococci, the rned gene present in S-horninis subsp. novobiosepticus was identified as homologue A, commonly found in S. aureus and many coagulase-negative staphylococcal species. The type strain of 5. horninis subsp. novobiosepticus is ATCC 700236l. Descriptions of S. horninis subsp. novobiosepticus subsp. nov. and 5. horninis subsp. horninis are given and the description of S. horninis is emended.

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“…With the exception of trimethoprim resistance determinants, similar genes were found among concurrently isolated multiply resistant S. epidermidis isolates from our hospitals. S. haemolyticus is a potentially important nosocomial species which readily acquires antimicrobial resistance genes and which shares, to some extent, in a common gene pool with S. epidermidis.Staphylococcus haemolyticus has been reported to represent an average of 10% of clinical coagulase-negative staphylococcal isolates (5,7,9,12,15,22,24,25,27,28). Many of these isolates have been found to be resistant to multiple antimicrobial agents.…”

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confidence: 99%

Antimicrobial resistance in nosocomial isolates of Staphylococcus haemolyticus

Froggatt

Johnston

Galetto

et al. 1989

Antimicrob Agents Chemother

169

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Staphylococcus haemolyticus is frequently cultured from hospitalized patients and is characterized by resistance to multiple antimicrobial agents. We found that S. haemolyticus represented 70 of 524 (13%) coagulase-negative staphylococcal isolates identified by the clinical microbiology laboratories of two hospitals over 2 months. S. haemolyticus isolates were recovered from wounds (44%), urine (26%), blood (10%), and other sources (20%). All S. haemolyticus isolates were tested for susceptibility to six antimicrobial agents; 77% were resistant to three or more agents, and 41% were resistant to five or six agents. In addition, among 47 multiply resistant isolates, high MICs (.6.25 ,ug/ml) of vancomycin (62% of isolates) and teicoplanin (91% of isolates) were found. DNA probes which were derived from S. epidermidis or S. aureus and which contained sequences associated with resistance to antimicrobial agents were used to detect specific genes in the total cellular and plasmid DNAs of 10 resistant S. haemolyticus isolates. Resistance gene probes and the numbers of resistant isolates hybridizing were as follows: methicillin, 10 of 10; gentamicin, 9 of 10; erythromycin, 7 of 10; and trimethoprim, 0 of 10. Genes for resistance to methicillin were found only in chromosomal locations, genes for resistance to gentamicin were found in both chromosomal and plasmid locations, and genes for resistance to erythromycin were found in plasmid locations only. With the exception of trimethoprim resistance determinants, similar genes were found among concurrently isolated multiply resistant S. epidermidis isolates from our hospitals. S. haemolyticus is a potentially important nosocomial species which readily acquires antimicrobial resistance genes and which shares, to some extent, in a common gene pool with S. epidermidis.Staphylococcus haemolyticus has been reported to represent an average of 10% of clinical coagulase-negative staphylococcal isolates (5,7,9,12,15,22,24,25,27,28). Many of these isolates have been found to be resistant to multiple antimicrobial agents. The importance of these organisms as human pathogens relative to that of other coagulase-negative staphylococci is uncertain, in part because species determinations of coagulase-negative staphylococci are not routinely done in most clinical microbiology laboratories. The mechanisms of antimicrobial resistance in S. haemolyticus and the extent to which it shares resistance genes with other staphylococci are also unknown. In a recent study of trimethoprim resistance among coagulase-negative staphylococci (6), we found that a specific trimethoprim resistance gene probe from a conjugative S. aureus plasmid hybridized with all trimethoprim-resistant S. epidermidis isolates but not with four S. haemolyticus isolates tested. The possibility of unique mechanisms of resistance in this poorly understood species led us to further investigate its characteristics.In the present study, we determined the proportion of S. haemolyticus isolates among clinical isolates of coagulasenega...

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Microbiologic studies of coagulase-negative staphylococci isolated from patients with nosocomial bacteraemias

Cited by 25 publications

References 24 publications

The ica Operon and Biofilm Production in Coagulase-Negative Staphylococci Associated with Carriage and Disease in a Neonatal Intensive Care Unit

The ica Operon and Biofilm Production in Coagulase-Negative Staphylococci Associated with Carriage and Disease in a Neonatal Intensive Care Unit

Staphylococcus hominis subsp. novobiosepticus subsp. nov., a novel trehalose- and N-acetyl-D-glucosamine-negative, novobiocin- and multiple-antibiotic-resistant subspecies isolated from human blood cultures

Antimicrobial resistance in nosocomial isolates of Staphylococcus haemolyticus

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