No abstract

OBJECTIVE: To study the presence and diversity of types of Staphylococcus epidermidis in the neonatal intensive care unit of a university hospital. METHODS: During a period of 6 weeks, samples were taken from nose, external auditory canal, axilla, groin and umbilicus from consecutively admitted patients. Patients were sampled two times a week for up to 2 weeks. Isolates of S. epidermidis were characterized by antibiogram, plasmid pattern and biotype. RESULTS: Fifteen patients were included. Each patient was sampled in one to four successive surveys, depending on the admission period. A total of 128 isolates of S. epidermidis were obtained and allocated to seven antibiogram types, 36 plasmid types and 14 biotypes. One plasmid type found in 58 isolates (six patients) corresponded with one multiresistant antibiogram type. The number of isolates with these characteristics increased per neonate from the first survey to the fourth. Nineteen isolates from four patients were allocated to a second plasmid type and were of a common antibiogram type. The remaining 34 plasmid types were sporadic. No clear correspondence of biotypes with antibiogram or plasmid types was found. CONCLUSIONS: The present study revealed the increase in colonization of a multiresistant type of S. epidermidis in the compromised patients during admission to the ward. Further studies have to assess whether this type remains persistent in the ward.

Methicillin-susceptible Staphylococcus aureus isolates, recovered from 204 patients in our hospital in a 22-month period, were characterized by pulsed-field gel electrophoresis. Among the multiple S. aureus types six clonal lineages dominated, comprising isolates from 158 patients. Despite the limited genetic variation, cross-transmission was made plausible only sporadically.

We observed two consecutive episodes of an outbreak of rotavirus (RV) on our neonatal medium care unit in May-June 2009. We investigated the genotype of the RV; describe the spread of the virus among neonates and the measures taken to control the outbreak. Stool samples of symptomatic neonates, and during the second episode stool samples of all neonates, were tested for RV antigens. Reverse transcriptase polymerase chain reaction was performed on ten samples positive for RV, followed by genotyping. Staff members and samples of the environment were also tested for RV. An infection control advisor attended shifts on the ward to observe the daily routines. Eighteen of 44 neonates were tested positive for RV antigen and RNA. Ten samples were genotyped and revealed the G9P[6] strain. One male premature neonate developed a serious neurologic complication. None of the staff members were positive for RV. It is concluded that the RV strain G9P[6] can present as a hard to eradicate nosocomial pathogen. Since atypical RV strains can cause severe illness among neonates, surveillance and genotyping during an outbreak is recommended.