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Staphylococcus epidermidis colonization is highly clonal across US cardiac centers
Rachel J Gordon1, Maria Miragaia, Alan D Weinberg
1Department of Medicine, Division of Infectious Diseases, Columbia University College of Physicians & Surgeons, New York, New York 10032, USA. rj216@columbia.edu
The Journal of Infectious Diseases
|March 30, 2012
Summary
Healthcare-associated Staphylococcus epidermidis infections, common in ventricular assist device (VAD) patients, are highly clonal. Specific antibiotic-resistant clones are widespread across US cardiac centers, posing a significant risk.
Area of Science:
- Clinical Microbiology
- Infectious Diseases
- Medical Device Infections
Background:
- Staphylococcus epidermidis is a leading cause of prosthetic material infections, particularly in ventricular assist device (VAD) recipients.
- The clonal nature and geographic distribution of S. epidermidis in the United States remain poorly understood.
Purpose of the Study:
- To investigate the clonality and antibiotic resistance profiles of Staphylococcus epidermidis isolates from VAD recipients in the US.
- To determine the prevalence and dissemination of specific S. epidermidis clones across multiple cardiac centers.
Main Methods:
- Prospective study of 75 VAD recipients across 4 US cardiac centers over 1 year.
- Collection of S. epidermidis isolates from nares, sternum, and driveline sites pre- and post-VAD insertion, along with infection isolates.
- Molecular typing using pulsed-field gel electrophoresis (PFGE), with a subset undergoing susceptibility testing and molecular characterization (SCCmec, MLST).
Main Results:
- Out of 565 typed S. epidermidis isolates, 46% belonged to 7 distinct clonal types identified by PFGE.
- These prevalent clones were found in up to 27 patients across all 4 centers and caused 3 of 6 VAD-related infections.
- Disseminated clones exhibited significantly higher rates of antibiotic resistance, including methicillin resistance (79% vs. 54%).
Conclusions:
- Healthcare-associated S. epidermidis infections are characterized by remarkable clonality.
- Specific, antibiotic-resistant S. epidermidis clones are distributed across US cardiac centers.
- These widespread clones may possess enhanced transmissibility, persistence, or invasiveness.
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