title: Coagulase-negative staphylococcal skin carriage among neonatal intensive care unit personnel: from population to infection.
abstract: Coagulase-negative staphylococci (CoNS) are a major cause of sepsis in neonatal intensive care units (NICU) worldwide. Infecting strains of these commensal bacteria may originate from NICU personnel. Therefore, we studied the characteristics of CoNS isolates from NICU personnel and compared them to those of isolates from the general population and from sepsis patients. Furthermore, we studied the epidemiological effect on CoNS carriage of NICU personnel after a period of absence. In our study, we isolated CoNS from the thumbs of NICU personnel every 2 weeks during the summer of 2005 and sampled personnel returning from vacation and a control group from the general population. Furthermore, we collected sepsis isolates from this period. Isolates were tested for antibiotic resistance, mecA and icaA carriage, biofilm production, and genetic relatedness. We found that mecA and icaA carriage as well as penicillin, oxacillin, and gentamicin resistance were significantly more prevalent in CoNS strains from NICU personnel than in community isolates. Similar trends were observed when postvacation strains were compared to prevacation strains. Furthermore, genetic analysis showed that 90% of the blood isolates were closely related to strains found on the hands of NICU personnel. Our findings revealed that CoNS carried by NICU personnel differ from those in the general population. Hospital strains are replaced by community CoNS after a period of absence. NICU personnel are a likely cause for the cross-contamination of virulent CoNS that originate from the NICU to patients.
authors.affiliation: Department of Pediatrics, Erasmus MC-Sophia Children’s Hospital, Rotterdam, The Netherlands.
authors.forename: Vishal
authors.initials: V
authors.lastname: Hira
authors.forename: Marcel
authors.initials: M
authors.lastname: Sluijter
authors.forename: Wil H F
authors.initials: WH
authors.lastname: Goessens
authors.forename: Alewijn
authors.initials: A
authors.lastname: Ott
authors.forename: Ronald
authors.initials: R
authors.lastname: de Groot
authors.forename: Peter W M
authors.initials: PW
authors.lastname: Hermans
authors.forename: René F
authors.initials: RF
authors.lastname: Kornelisse
mesh_terms: D000328:Adult; D015373:Bacterial Typing Techniques; D002353:Carrier State / Q000382:microbiology*; D003030:Coagulase / Q000378:metabolism; D016172:DNA Fingerprinting; D005260:Female; D005798:Genes, Bacterial; D005838:Genotype; D006282:Health Personnel; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D008297:Male; D008826:Microbial Sensitivity Tests; D018805:Sepsis / Q000382:microbiology; D012867:Skin / Q000382:microbiology*; D013207:Staphylococcal Skin Infections / Q000382:microbiology*; D013210:Staphylococcus / Q000145:classification / Q000302:isolation & purification*; D013933:Thumb / Q000382:microbiology; D055815:Young Adult
chemical_list: D003030:Coagulase
references.citation: Am J Infect Control. 1994 Dec;22(6):346-51
references.pmid: 7695113
references.citation: Am J Infect Control. 2007 May;35(4):231-6
references.pmid: 17482994
references.citation: Can Med Assoc J. 1957 Dec 1;77(11):1001-9
references.pmid: 13489588
references.citation: Infect Control Hosp Epidemiol. 2004 May;25(5):431-5
references.pmid: 15188851
references.citation: J Bacteriol. 2002 Aug;184(16):4400-8
references.pmid: 12142410
references.citation: J Med Microbiol. 2006 Mar;55(Pt 3):317-324
references.pmid: 16476796
references.citation: Pediatr Infect Dis J. 2005 Sep;24(9):817-22
references.pmid: 16148849
references.citation: Antimicrob Agents Chemother. 1999 Apr;43(4):727-37
references.pmid: 10103173
references.citation: J Pediatr. 2001 Dec;139(6):821-7
references.pmid: 11743507
references.citation: Eur J Clin Microbiol Infect Dis. 1990 Jun;9(6):381-9
references.pmid: 2387290
references.citation: Clin Microbiol Infect. 2007 Nov;13(11):1100-11
references.pmid: 17850346
references.citation: J Clin Microbiol. 2004 Nov;42(11):4947-55
references.pmid: 15528678
references.citation: Pediatr Infect Dis J. 2007 Jul;26(7):607-12
references.pmid: 17596803
references.citation: Pediatrics. 2007 Aug;120(2):e382-90
references.pmid: 17664257
references.citation: Pediatr Infect Dis J. 1992 Nov;11(11):935-40
references.pmid: 1454435
references.citation: Infect Control Hosp Epidemiol. 2007 Mar;28(3):326-30
references.pmid: 17326024
references.citation: J Clin Microbiol. 2002 Feb;40(2):382-8
references.pmid: 11825946