title: Methicillin-resistant Staphylococcus caprae in a neonatal intensive care unit.
abstract: Staphylococcus caprae, a hemolytic coagulase-negative staphylococcus that is infrequently associated with humans, was initially detected in specimens from six infants in our neonatal intensive care unit due to phenotypic characteristics common to methicillin-resistant Staphylococcus aureus. These isolates were subsequently identified as S. caprae by the Automated RiboPrinter microbial characterization system. This prompted an 8-month retrospective investigation in our neonatal intensive care unit. S. caprae was the cause of 6 of 18 episodes of coagulase-negative staphylococcal bacteremia, was the most common coagulase-negative staphylococcus recovered from the nares of 6 of 32 infants surveyed in a methicillin-resistant S. aureus surveillance program, and was isolated from 1 of 37 health care providers' hands. Of 13 neonatal intensive care unit isolates tested, all were methicillin resistant and positive for the mecA gene. All 21 isolates were found to be a single strain by Automated RiboPrinter and pulsed-field gel electrophoresis with ApaI or SmaI digestion; ApaI was more discriminating in analyzing epidemiologically unrelated strains than Automated RiboPrinter or electrophoresis with SmaI. These findings extend the importance of S. caprae, emphasize its similarities to methicillin-resistant S. aureus, and demonstrate its ability to persist in an intensive care unit setting.
authors.affiliation: Department of Pathology, The Johns Hopkins Hospital, Baltimore, MD 21287-7093, USA.
authors.forename: T L
authors.initials: TL
authors.lastname: Ross
authors.forename: E P
authors.initials: EP
authors.lastname: Fuss
authors.forename: S M
authors.initials: SM
authors.lastname: Harrington
authors.forename: M
authors.initials: M
authors.lastname: Cai
authors.forename: T M
authors.initials: TM
authors.lastname: Perl
authors.forename: W G
authors.initials: WG
authors.lastname: Merz
mesh_terms: D000328:Adult; D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology; D003030:Coagulase / Q000378:metabolism; D016521:Electrophoresis, Gel, Pulsed-Field; D005838:Genotype; D006225:Hand / Q000382:microbiology; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D009296:Nasal Cavity / Q000382:microbiology; D010641:Phenotype; D012189:Retrospective Studies; D021521:Ribotyping; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D013210:Staphylococcus / Q000145:classification* / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification
chemical_list: D003030:Coagulase