Colonization pattern of coagulase-negative staphylococci in preterm neonates and the relation to bacteremia
Colonization pattern of coagulase-negative staphylococci in preterm neonates and the relation to bacteremia
复制标题
DOI：
10.1007/s10096-010-0966-3
复制
发表时间：
2010-09-01
影响因子：
4.5
通讯作者：
Soderquist, B.
中科院分区：
文献类型：
--
作者：
Bjorkqvist, M.;Liljedahl, M.;Soderquist, B.
凝固酶阴性葡萄球菌（CoNS）是极早产（EPT）新生儿败血症的主要原因，但关于EPT新生儿在侵袭性感染前CoNS定植的数据有限。我们的目的是描述早期建立的CoNS菌群在EPT新生儿，并比较殖民模式，在新生儿和无阳性CoNS血培养。从一组46名EPT新生儿中，确定了CoNS血培养阳性的新生儿（n = 10），并与匹配的对照组进行了比较。从鼻孔、会阴和脐部重复采集细菌培养样本。使用PhenePlate系统对所有CoNS分离株进行生化指纹图谱表征。7/20的新生儿在分娩后第2-3天发现持续性CoNS菌株，并且有在鼻孔中比在会阴或脐部更早定植的趋势。在血培养呈阳性之前，CoNS血液菌株在表面部位普遍存在（11/14血液菌株），但没有发现单一的侵入性途径。大多数CoNS血液菌株（9/14）在抗生素治疗后仍在浅表部位存在。我们假设新生儿CoNS败血症的侵袭途径是复杂的，粘膜和脐导管的定植可能同样重要。
Coagulase-negative staphylococci (CoNS) are the major cause of sepsis in extreme preterm (EPT) newborns, but data on the CoNS colonization in EPT newborns prior to invasive infection are limited. Our aim was to describe the early establishment of the CoNS microflora in EPT newborns and to compare the colonization pattern in neonates with and without positive CoNS blood cultures. From a cohort of 46 EPT neonates, newborns with positive CoNS blood culture were identified (n = 10) and compared with matched controls. Samples for bacterial cultures were obtained repetitively from nares, perineum, and umbilicus. All CoNS isolates were characterized using the PhenePlate system for biochemical fingerprinting. Persistent CoNS strains were found on day 2-3 after delivery in 7/20 newborns, and there was a tendency for earlier colonization in nares than in the perineum or umbilicus. The CoNS blood strains were prevalent in superficial sites prior to positive blood culture (11/14 blood strains), but no single invasive pathway was identified. Most CoNS blood strains (9/14) persisted on superficial sites after antibiotic treatment. We hypothesize that the invasive pathways in neonatal CoNS sepsis are complex and that the colonization of mucosal membranes and umbilical catheters might be of equal importance.