Staphylococcus capitis: Review of Its Role in Infections and Outbreaks

Area of Science:

• Medical Microbiology
• Infectious Diseases
• Public Health

Background:

• Staphylococcus capitis is a known cause of outbreaks in neonatal units globally.
• The extent of S. capitis spread and associated outbreak clones in the UK was previously unclear.
• A national incident was declared in June 2021 due to increased detection in hospitalized infants.

Purpose of the Study:

• To review existing literature on Staphylococcus capitis outbreaks.
• To support case identification and clinical management strategies.
• To inform environmental infection control measures for neonatal units.

Main Methods:

• A comprehensive literature search was conducted across multiple databases.
• Keywords included Staphylococcus capitis, NRCS-A, neonate, and NICU.
• 223 relevant articles were included after screening.

Main Results:

• S. capitis outbreaks are frequently linked to the NRCS-A clone and environmental sources.
• The NRCS-A clone exhibits multidrug resistance, including to beta-lactam antibiotics and aminoglycosides.
• Vancomycin resistance or heteroresistance and a novel SCCmec-SCCcad/ars/cop island were noted in the NRCS-A clone.

Conclusions:

• The NRCS-A clone has been detected for decades, but reasons for potential increased frequency are unclear.
• Effective interventions for managing S. capitis NRCS-A outbreaks require further investigation.
• Enhanced environmental control and decontamination strategies are crucial to prevent transmission.