Sources and reservoirs of Staphylococcus capitis NRCS-A inside a NICU

Abstract

Background The methicillin-resistant clone Staphylococcus capitis NRCS-A, involved in sepsis in neonatal intensive care units (NICUs) worldwide, is able to persist and spread in NICUs, suggesting the presence of reservoirs inside each setting. The purpose of the present study was to identify these reservoirs and to investigate the cycle of transmission of NRCS-A in one NICU. Methods In a single institution study, NRCS-A was sought in 106 consecutive vaginal samples of pregnant women to identify a potential source of NRCS-A importation into the NICU. Additionally NICU caregivers and environmental including incubators were tested to identify putative secondary reservoirs. Finally, the efficacy of disinfection procedure in the elimination of NRCS-A from incubators was evaluated. Results No S. capitis was isolated from vaginal samples of pregnant women. Three of the 21 tested caregivers (14%) carried S. capitis on their hands, but none remain positive after a five-day wash-out period outside NICU. Moreover, the clone NRCS-A persisted during six consecutive weeks in the NICU environment, but none of the sampled sites was constantly contaminated. Finally in our before/after disinfection study, all of 16 incubators were colonized before disinfection and 10 (62%) incubators remained colonized with NRCS-A after the disinfection procedure. Conclusions The partial ineffectiveness of incubators’ disinfection procedures is responsible for persistence of NRCS-A inside a NICU, and the passive hand contamination of caregivers could be involved in the inter-patient transmission of S. capitis.

Endogenous endophthalmitis caused by Staphylococcus capitis

“…Staphylococcus capitis is an opportunistic pathogen that usually causes skin and soft tissues infections and is a common pathogen implicated in nosocomial blood infections in intensive care units. 10 , 11 In this report, we describe an unusual case of endogenous endophthalmitis caused by Staphylococcus capitis. Only very few cases of Staphylococcus capitis exogenous endophthalmitis have been reported in the literature to date.…”

Evidence Map and Systematic Review of Disinfection Efficacy on Environmental Surfaces in Healthcare Facilities

“…This systematic review rigorously catalogues evidence concerning the first question regarding disinfection efficacy. Other questions include the persistence or residual effect of the disinfectants that are more commonly studied among surface and vapor disinfectant interventions than among manually applied disinfectants (see, e.g., [ 63 , 64 , 102 , 103 , 132 , 166 , 180 ], the efficacy of the disinfectant when in the presence of increased biofilm or organic material (see, e.g., [ 49 , 56 , 110 , 145 , 197 , 201 ]), and whether pre-cleaning is needed (see, e.g., [ 123 , 141 , 193 ]).…”

“…Safety criteria ensure that the disinfectant does not have unintended side effects. We identified themes around disinfectants contributing to chemical or antimicrobial resistance (e.g., [ 44 , 62 , 69 , 110 , 158 ]) and toxicity or discomfort to healthcare workers and patients (see, e.g., [ 49 , 134 , 135 , 137 , 145 , 164 , 165 , 182 , 196 , 213 , 219 , 220 , 222 ]) as well as the compatibility of the disinfectant on surfaces and clothing (see, e.g., [ 61 , 69 , 83 , 85 , 139 , 145 , 172 , 189 , 220 ]).…”

The ecology and antimicrobial resistance of Staphylococci colonising neonates

“…Staphylococcus capitis; a NICU adapted sub-clade o A specific clone of S. capitis 'NRCS-A' has been identified worldwide as adapted to the NICU environment, and infection of neonates with this clone has been associated with higher morbidity and mortality rates than other CoNS (6). o Using ROARY (8) core genome alignments distinguished the S. capitis isolates into three clusters (Figure 3).…”