title: Genotypic study documents divergence in the pathogenesis of bloodstream infection related central venous catheters in neonates.
abstract: OBJECTIVE
  To investigate the pathogenesis of bloodstream infection by Staphylococcus epidermidis, using the molecular epidemiology, in high-risk neonates.
  
  
  METHODS
  We conducted a prospective study of a cohort of neonates with bloodstream infection using central venous catheters for more than 24h. "National Healthcare Safety Network" surveillance was conducted. Genotyping was performed by DNA fingerprinting and mecA genes and icaAD were detected by multiplex-PCR.
  
  
  RESULTS
  From April 2006 to April 2008, the incidence of bloodstream infection and central venous catheter-associated bloodstream infection was 15.1 and 13.0/1000 catheter days, respectively, with S. epidermidis accounting for 42.9% of episodes. Molecular analysis was used to document the similarity among six isolates of bloodstream infection by S. epidermidis from cases with positive blood and central venous catheter tip cultures. Fifty percent of neonates had bloodstream infection not identified as definite or probable central venous catheter-related bloodstream infection. Only one case was considered as definite central venous catheter-related bloodstream infection and was extraluminally acquired; the remaining were considered probable central venous catheter-related bloodstream infections, with one probable extraluminally and another probable intraluminally acquired bloodstream infection. Additionally, among mecA+ and icaAD+ samples, one clone (A) was predominant (80%). A polyclonal profile was found among sensitive samples that were not carriers of the icaAD gene.
  
  
  CONCLUSIONS
  The majority of infections caused by S. epidermidis in neonates had an unknown origin, although 33.3% appeared to have been acquired intraluminally and extraluminally. We observed a polyclonal profile between sensitive samples and a prevalent clone (A) between resistant samples.
authors.affiliation: Laboratório de Microbiologia, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia (UFU), Campus Umuarama, Uberlândia, MG, Brazil. Electronic address: cristianebrito08@yahoo.com.br.
authors.forename: Cristiane Silveira
authors.initials: CS
authors.lastname: Brito
authors.affiliation: Laboratório de Microbiologia, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia (UFU), Campus Umuarama, Uberlândia, MG, Brazil.
authors.forename: Rosineide Marques
authors.initials: RM
authors.lastname: Ribas
authors.affiliation: Laboratório de Microbiologia, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia (UFU), Campus Umuarama, Uberlândia, MG, Brazil.
authors.forename: Daiane Silva
authors.initials: DS
authors.lastname: Resende
authors.affiliation: Laboratório de Microbiologia, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia (UFU), Campus Umuarama, Uberlândia, MG, Brazil.
authors.forename: Denise Von Dolinger de
authors.initials: DV
authors.lastname: Brito
authors.affiliation: Unidade de Terapia Intensiva Neonatal, Hospital de Clínicas da Universidade Federal de Uberlândia (UFU), Campus Umuarama, Uberlândia, MG, Brazil.
authors.forename: Vânia Olivetti Steffen
authors.initials: VO
authors.lastname: Abdallah
authors.affiliation: Departamento de Microbiologia Médica, Instituto de Microbiologia Prof. Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Kátia Regina Netto dos
authors.initials: KR
authors.lastname: Santos
authors.affiliation: Departamento de Microbiologia Médica, Instituto de Microbiologia Prof. Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Fernanda Sampaio
authors.initials: FS
authors.lastname: Cavalcante
authors.affiliation: Departamento de Microbiologia Médica, Instituto de Microbiologia Prof. Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Pricilla Dias Moura de
authors.initials: PD
authors.lastname: Matos
authors.affiliation: Laboratório de Microbiologia, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia (UFU), Campus Umuarama, Uberlândia, MG, Brazil.
authors.forename: Paulo P
authors.initials: PP
authors.lastname: Gontijo Filho
mesh_terms: D016470:Bacteremia / Q000382:microbiology*; D055499:Catheter-Related Infections / Q000382:microbiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D015331:Cohort Studies; D003428:Cross Infection / Q000382:microbiology*; D016172:DNA Fingerprinting; D004269:DNA, Bacterial / Q000032:analysis; D016521:Electrophoresis, Gel, Pulsed-Field; D005838:Genotype; D006801:Humans; D007231:Infant, Newborn; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D013203:Staphylococcal Infections / Q000382:microbiology*; D013212:Staphylococcus epidermidis / Q000235:genetics* / Q000302:isolation & purification
chemical_list: D004269:DNA, Bacterial
keywords: Central venous catheter; Neonates; Pathogenesis