Prevalence of methicillin-resistant, coagulase-negative staphylococci in neonatal intensive care units: findings from a tertiary care hospital in India

Abstract

This study was undertaken to determine the antimicrobial resistance pattern and species of coagulase-negative staphylococci (CNS) isolated from the blood and skin of neonates with clinical suspicion of late-onset septicaemia (.72 h post-delivery) admitted to neonatal intensive care units, with particular reference to the phenotypic and genotypic expression of methicillin resistance. Blood culture specimens were collected by venipuncture from 660 such neonates in brain heart infusion broth. Skin swabs from axillae were obtained from 60 neonates and inoculated on mannitol salt agar. All CNS thus obtained were further identified and antibiotic sensitivity was performed according to NCCLS recommendations. PCR for the mecA gene was carried out on 54 randomly selected isolates. Staphylococcus haemolyticus was the commonest species (34 %) followed by Staphylococcus epidermidis (24 %) amongst blood isolates. All blood isolates were sensitive to glycopeptides. Resistance to penicillin and methicillin was 94 and 66 %, respectively. Similar biotypes and antimicrobial resistance patterns were observed in skin isolates. All phenotypically methicillin-resistant isolates had the mecA gene and two of the phenotypically methicillin-sensitive isolates were also positive for mecA. A PCR assay for detection of the mecA gene in CNS may be a beneficial adjunct to standard susceptibility testing for timely and reliable detection of methicillin resistance. Given the large number of methicillin-resistant CNS, inclusion of vancomycin in empiric therapy for neonates with late-onset septicaemia may be justified.

Characterization and Antibiotic Susceptibility Pattern of Coagulase Negative Staphylococci with Special Reference to Methicillin Resistance

“…Incidence of MRCONS is increasing day by day. High incidence of MRCONS were reported by Seetha et al, (82.77%) [2] , Singhal R et al, (72.3%) [8] and Jain, Agarwal and Bansal (66.0%) [16], the incidence of MRCONS varies from 14.6% [15] to 38.0% [14] . We can conclude that MRCONS incidences were high among the CONS isolated from the super-speciality hospitals and intensive care units of tertiary care hospitals.…”

“…Variability in the antibiotic susceptibility pattern of CONS has been observed by few author [ 8,12,16] which reflects the different antibiotics policies followed by different hospitals.…”

Isolation and Molecular Characterization of Staphylococcus sciuri in the Hospital Environment

“…Isolation of S. sciuri from hospitalized patients has been reported (1,14,18,24), but its occurrence in hospital environment has not been investigated so far. The present study is the first evaluation of S. sciuri colonization of a hospital environment and characterization of the obtained isolates.…”

Bacterial Etiology and Antibacterial Susceptibility Patterns of Pediatric Bloodstream Infections: A Two Year Study From Nemazee Hospital, Shiraz, Iran

“…However, in Japoni et al's study, because of the study design and elimination of CoNS results for their potential contamination of adult blood cultures, Staphylococcus aureus was reported as the most frequent Gram positive cocci (25%) (16). In our study, the S. aureus isolation rate reached a maximum of 1.4%, and considering the important role of CoNS in nosocomial infections of the neonatal and pediatric population (22)(23)(24), S. epidermidis was the most frequent Gram positive cocci, with an isolation rate of 48.6%. In addition, the results from repeated sampling and cultures do not suggest the possibility of contamination of specimens.…”