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Methicillin-resistant Staphylococcus capitis with reduced vancomycin susceptibility causes late-onset sepsis in

Jean-Philippe Rasigade1, Olivia Raulin, Jean-Charles Picaud

  • 1INSERM U851, National Reference Center for Staphylococci, University of Lyon, Lyon, France. jean-philippe.rasigade@chu-lyon.fr

Plos One
|February 21, 2012
PubMed
Abstract

Insights

Methicillin-resistant Staphylococcus capitis is a growing threat in neonatal intensive care units (NICUs), showing reduced susceptibility to vancomycin. This study highlights a specific clonal strain spreading in French NICUs, necessitating further investigation and surveillance.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Neonatal Care

Background:

  • Coagulase-negative staphylococci, primarily Staphylococcus epidermidis, are common causes of late-onset sepsis (LOS) in neonatal intensive care units (NICUs).
  • Emerging reports suggest methicillin-resistant, vancomycin-heteroresistant Staphylococcus capitis may be a significant NICU pathogen.
  • This study investigates the prevalence, clonality, and vancomycin susceptibility of S. capitis in NICU infants compared to adult patients.

Purpose of the Study:

  • To determine the prevalence of Staphylococcus capitis bloodstream infections in NICU infants.
  • To analyze the clonality and antibiotic susceptibility, particularly to vancomycin, of S. capitis isolates from NICU infants.
  • To compare S. capitis epidemiology and resistance patterns between NICU infants and adult intensive care unit (ICU) patients.

Main Methods:

  • Retrospective laboratory-based survey of positive blood cultures from NICU infants (n=527) and adult ICU patients (n=1473) between 2004-2009.
  • Identification and characterization of Staphylococcus capitis isolates, including pulsed-field gel electrophoresis (PFGE) for clonality assessment.
  • Determination of methicillin and vancomycin susceptibility, including heteroresistance, for all S. capitis isolates.

Main Results:

  • Staphylococcus capitis was the most frequent pathogen in NICU infants (39.1%), surpassing S. epidermidis (23.5%), but rare in adult ICUs (1.0%).
  • Methicillin resistance was significantly higher in S. capitis from NICU infants (95.6%) compared to adults (53.3%).
  • A clonal population of methicillin-resistant S. capitis strains from NICU infants showed high rates of vancomycin resistance (37.5%) or heteroresistance (62.5%), distinct from genetically diverse adult isolates.

Conclusions:

  • A specific clonal population of methicillin-resistant Staphylococcus capitis has disseminated across multiple French NICUs.
  • These NICU-associated S. capitis strains exhibit concerning reduced susceptibility to vancomycin.
  • The findings underscore the need for enhanced surveillance and infection control strategies targeting S. capitis in NICU settings.

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