Comparison of community-acquired methicillin-resistant Staphylococcus aureus bacteremia to other staphylococcal species in a neonatal intensive care unit

  • Jacob Kuint
  • Asher Barzilai
  • Gili Regev-Yochay
  • Ethan Rubinstein
  • Nati Keller
  • Ayala Maayan-Metzger
Original Paper

Abstract

Hospital acquired infections including staphylococcal species are common in neonatal intensive care units. Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) was recently observed in our unit. The clinical and laboratory characteristics of all neonates with Staphylococcus aureus bacteremia during an 11-year period were retrospectively reviewed. Three groups of patients were compared: 1. Patients with CA-MRSA defined as MRSA-resistant only to β-lactams, but sensitive to all other antibiotic groups and carried SCCmec IV. 2. Patients with multi-drug-resistant (MDR)-MRSA and 3. Patients with MSSA (methicillin-sensitive S. aureus). Forty-three neonates with documented S. aureus bacteremia were included. Of these 41 were preterm babies. Eleven infants had CA-MRSA, 20 had MDR-MRSA and 12 had MSSA bacteremia, the Panton-Valentine-Leukocidine gene (pvl-gene) was not present in any of these strains. Risk factors, clinical manifestations and laboratory tests were similar in all three groups studied. Although neonates infected with CA-MRSA were more premature and had more related diseases, the mortality rate was similar in all groups (9.1% in the CA-MRSA group). Skin infections, osteomyelitis or pneumatocele were not observed more frequently in the CA-MRSA group. We did not find significant differences in risk factors or outcomes in neonates in the three groups. One possible explanation for this observation is that the CA-MRSA outbreak strain did not contain the pvl-gene, which has been suggested to be a significant virulence factor.

Keywords

Newborn infants Community-associated methicillin-resistant Staphylococcus aureus Bacteremia 

Abbreviations

MRSA

Methicillin-resistant S. aureus

CA-MRSA

Community-associated methicillin-resistant Staphylococcus aureus

MDR

multi drug resistance

MSSA

methicillin-sensitive S. aureus

pvl-gene

Panton-Valentine-Leukocidine gene

VLBW

very low birth weight

NICU

neonatal intensive care units

NA-MRSA

nosocomially acquired MRSA

BW

birth weight

GA

gestational age

PROM

prolonged rupture of membranes

RDS

respiratory distress syndrome

BPD

broncho-pulmonary dysplasia

IVH

intraventricular hemorrhage

PVL

periventricular leukomalacia

NEC

necrotizing enterocolitis

ROP

retinopathy of prematurity

TSA

tryptic soy agar

PCR

chain reaction

VSD

ventricular septal defect

SGA

small for gestational age

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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Jacob Kuint
    • 1
    • 2
  • Asher Barzilai
    • 1
  • Gili Regev-Yochay
    • 1
  • Ethan Rubinstein
    • 1
  • Nati Keller
    • 1
  • Ayala Maayan-Metzger
    • 1
  1. 1.Neonatal DepartmentThe Edmond and Lili Safra Children’s Hospital, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv UniversityTel AvivIsrael
  2. 2.Department of NeonatologySheba Medical CenterTel AvivIsrael

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