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Sources and reservoirs of Staphylococcus capitis NRCS-A inside a NICU
Marine Butin1,2, Yann Dumont3, Alice Monteix3
11Centre International de Recherche en Infectiologie (CIRI), INSERM U1111, CNRS UMR5308, Ecole Normale Supérieure de Lyon, Université Claude Bernard Lyon 1, 46 Allée d'Italie, 69364 Lyon Cedex 07, France.
Background:
The methicillin-resistant clone Staphylococcus capitis NRCS-A, involved in sepsis in neonatal intensive care units (NICUs) worldwide, is able to persist and spread in NICUs, suggesting the presence of reservoirs inside each setting. The purpose of the present study was to identify these reservoirs and to investigate the cycle of transmission of NRCS-A in one NICU.
Methods:
In a single institution study, NRCS-A was sought in 106 consecutive vaginal samples of pregnant women to identify a potential source of NRCS-A importation into the NICU. Additionally NICU caregivers and environmental including incubators were tested to identify putative secondary reservoirs. Finally, the efficacy of disinfection procedure in the elimination of NRCS-A from incubators was evaluated.
Results:
No S. capitis was isolated from vaginal samples of pregnant women. Three of the 21 tested caregivers (14%) carried S. capitis on their hands, but none remain positive after a five-day wash-out period outside NICU. Moreover, the clone NRCS-A persisted during six consecutive weeks in the NICU environment, but none of the sampled sites was constantly contaminated. Finally in our before/after disinfection study, all of 16 incubators were colonized before disinfection and 10 (62%) incubators remained colonized with NRCS-A after the disinfection procedure.
Conclusions:
The partial ineffectiveness of incubators' disinfection procedures is responsible for persistence of NRCS-A inside a NICU, and the passive hand contamination of caregivers could be involved in the inter-patient transmission of S. capitis.
Insights
Methicillin-resistant Staphylococcus capitis NRCS-A persists in NICUs due to ineffective incubator disinfection. Caregiver hand contamination may also contribute to its spread among neonates.
Area of Science:
- Infectious Diseases
- Neonatal Care
- Microbiology
Background:
- Methicillin-resistant *Staphylococcus capitis* NRCS-A is a significant cause of sepsis in neonatal intensive care units (NICUs) globally.
- Its persistence and spread within NICUs suggest the presence of environmental reservoirs.
- Identifying these reservoirs is crucial for controlling transmission.
Purpose of the Study:
- To identify reservoirs of *Staphylococcus capitis* NRCS-A within a NICU.
- To investigate the transmission cycle of NRCS-A in a neonatal intensive care setting.
- To evaluate the effectiveness of disinfection protocols for eliminating NRCS-A.
Main Methods:
- Vaginal samples from pregnant women were tested for NRCS-A to assess importation risk.
- NICU caregivers and environmental sites, including incubators, were sampled.
- A before-and-after study evaluated the efficacy of incubator disinfection procedures.
Main Results:
- No *S. capitis* was found in maternal vaginal samples.
- 14% of caregivers had transient hand contamination; no persistent carriage was observed.
- NRCS-A persisted in the NICU environment for six weeks, with no single site consistently contaminated.
- 62% of incubators remained colonized with NRCS-A even after disinfection.
Conclusions:
- Partially ineffective incubator disinfection contributes to the persistence of NRCS-A in NICUs.
- Passive hand contamination of caregivers may play a role in the inter-patient transmission of *S. capitis*.
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