title: Is hospital-acquired intravascular catheter-related sepsis associated with outbreak strains of coagulase-negative staphylococci?
abstract: Macrorestriction fragment profile analysis by pulsed field gel electrophoresis was used to type strains of coagulase-negative staphylococci (CNS) isolated from 30 patients with catheter-related sepsis at the University Hospital Birmingham NHS Trust, UK. Twenty-three infections were hospital-acquired. A total of 56 CNS were isolated from the patients and identified by API as Staphylococcus epidermidis (54), Staphylococcus lugdunensis (1) and Staphylococcus hominis (1). The micro-organisms were further characterized by antibiograms and restriction digestion using SmaI. Analysis of the macrorestriction fragment profiles demonstrated that the isolates from 24 patients were distinct, whereas a common genotype of S. epidermidis was isolated from the blood cultures of six patients, all of whom had acquired this infection in hospital. Three of these patients were located in a haematology ward, two on an intensive care unit and one on a dialysis unit. The data from this current study suggests that specific strains of S. epidermidis may be an important cause of nosocomial catheter-related sepsis resulting from cross-infection, and that this association would not be detected by conventional typing methods including biotyping and antibiograms.
authors.affiliation: Department of Clinical Microbiology, University Hospital Birmingham NHS Trust, Queen Elizabeth, Edgbaston, Birmingham, B15 2TH, UK.
authors.forename: T
authors.initials: T
authors.lastname: Worthington
authors.forename: P A
authors.initials: PA
authors.lastname: Lambert
authors.forename: T S
authors.initials: TS
authors.lastname: Elliott
mesh_terms: D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D003030:Coagulase; D003428:Cross Infection / Q000209:etiology*; D004269:DNA, Bacterial / Q000032:analysis / Q000235:genetics; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D016521:Electrophoresis, Gel, Pulsed-Field / Q000379:methods; D004739:England; D006785:Hospitals, University; D006801:Humans; D017053:Infection Control / Q000379:methods; D008826:Microbial Sensitivity Tests / Q000379:methods; D015183:Restriction Mapping / Q000379:methods; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000209:etiology*; D012703:Serotyping / Q000379:methods; D013203:Staphylococcal Infections / Q000209:etiology*; D013210:Staphylococcus / Q000145:classification* / Q000201:enzymology / Q000235:genetics; D013212:Staphylococcus epidermidis / Q000145:classification* / Q000201:enzymology / Q000235:genetics
chemical_list: D003030:Coagulase; D004269:DNA, Bacterial