title: Epidemiology, antibiotic consumption and molecular characterisation of Staphylococcus aureus infections--data from the Polish Neonatology Surveillance Network, 2009-2012.
abstract: BACKGROUND
  Our aim was to determine and characterize S. aureus (SA) isolated from infections in newborns for antibiotic resistance, virulence factors, genotypes, epidemiology and antibiotic consumption.
  
  
  METHODS
  Prospective surveillance of infections was conducted. Data about antibiotic treatment were analyzed. Antimicrobial susceptibility was assessed. PCR amplification was used to detect resistance and virulence genes. Typing methods such as PFGE, spa-typing and SCCmec were used.
  
  
  RESULTS
  SA was found to be associated with 6.5% of infections. Methicillin-Resistant Staphylococcus aureus accounted for 32.8% of SA-infections. An incidence of MRSA-infections was 1.1/1000 newborns. MRSA-infections were diagnosed significantly earlier than MSSA-infections in these newborns (14th day vs. 23rd day (p=0.0194)). MRSA-infections increased the risk of newborn's death. Antibiotic consumption in both group was similar, but a high level of glycopeptides-usage for MSSA infections was observed. In the MRSA group, more strains were resistant to erythromycin, clindamycin, gentamicin and amikacin than in the MSSA group. Hla gene was present in 93.9% of strains, and seg and sei in 65.3% of strains, respectively. One dominant clone was found among the 14 MRSA isolates. Fifteen strains belonging to SCCmec type IV were spa-t015 and one strain belonging to SCCmec type V was spa-t011.
  
  
  CONCLUSIONS
  Results obtained in the study point at specific epidemiological situation in Polish NICU (more detailed studies are recommended). High usage of glycopeptides in the MSSA infections treatment indicates the necessity of antimicrobial stewardship improvement and introducing molecular screening for early identification of infections.
authors.affiliation: Chair of Microbiology, Jagiellonian University Medical College, 18 Czysta Street, Kracow, 31-121, Poland. d.romaniszyn@uj.edu.pl.
authors.forename: Dorota
authors.initials: D
authors.lastname: Romaniszyn
authors.affiliation: Chair of Microbiology, Jagiellonian University Medical College, 18 Czysta Street, Kracow, 31-121, Poland. rozanska@ifb.pl.
authors.forename: Anna
authors.initials: A
authors.lastname: Różańska
authors.affiliation: Chair of Microbiology, Jagiellonian University Medical College, 18 Czysta Street, Kracow, 31-121, Poland. mbmach@cyf-kr.edu.pl.
authors.forename: Jadwiga
authors.initials: J
authors.lastname: Wójkowska-Mach
authors.affiliation: Chair of Microbiology, Jagiellonian University Medical College, 18 Czysta Street, Kracow, 31-121, Poland. agnieszka.chmielarczyk@uj.edu.pl.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Chmielarczyk
authors.affiliation: Chair of Microbiology, Jagiellonian University Medical College, 18 Czysta Street, Kracow, 31-121, Poland. monika.pobiega@gmail.com.
authors.forename: Monika
authors.initials: M
authors.lastname: Pobiega
authors.affiliation: Institute of Nature Conservation, Polish Academy of Sciences, Kraków, Poland. adamski@iop.krakow.pl.
authors.forename: Paweł
authors.initials: P
authors.lastname: Adamski
authors.affiliation: Clinic of Neonatology and Intensive Neonatal Care, Institute of Mother and Child, Warsaw, Poland. sekretariat.neonatologii@imid.med.pl.
authors.forename: Ewa
authors.initials: E
authors.lastname: Helwich
authors.affiliation: Clinic of Neonatology, Jagiellonian University Medical College, Kraków, Poland. ryszard.lauterbach@uj.edu.pl.
authors.forename: Ryszard
authors.initials: R
authors.lastname: Lauterbach
authors.affiliation: Clinic of Neonatology and Intensive Neonatal Care, Warsaw Medical University, Warsaw, Poland. mariak@szpitalkarowa.pl.
authors.forename: Maria
authors.initials: M
authors.lastname: Borszewska-Kornacka
authors.affiliation: Clinic of Neonatology, Polish Mother's Memorial Hospital-Research Institute, Lodz, Poland. ewagulcz@wp.pl.
authors.forename: Ewa
authors.initials: E
authors.lastname: Gulczyńska
authors.affiliation: Department of Neonatal Diseases, Pomeranian Medical University, Szczecin, Poland. agkordek@sci.pum.edu.pl.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Kordek
authors.affiliation: Chair of Microbiology, Jagiellonian University Medical College, 18 Czysta Street, Kracow, 31-121, Poland. mbulanda@post.pl.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Bulanda
mesh_terms: D000583:Amikacin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015373:Bacterial Typing Techniques; D002981:Clindamycin / Q000627:therapeutic use; D015331:Cohort Studies; D004269:DNA, Bacterial / Q000235:genetics*; D004352:Drug Resistance, Microbial / Q000235:genetics*; D004917:Erythromycin / Q000627:therapeutic use; D005260:Female; D005839:Gentamicins / Q000627:therapeutic use; D005865:Gestational Age; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000235:genetics* / Q000302:isolation & purification / Q000502:physiology; D008826:Microbial Sensitivity Tests; D017720:Molecular Epidemiology; D011044:Poland / Q000453:epidemiology; D011446:Prospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology; D037521:Virulence Factors / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D005839:Gentamicins; D037521:Virulence Factors; D002981:Clindamycin; D004917:Erythromycin; D000583:Amikacin