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


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.


Newborn infants Community-associated methicillin-resistant Staphylococcus aureus Bacteremia 



Methicillin-resistant S. aureus


Community-associated methicillin-resistant Staphylococcus aureus


multi drug resistance


methicillin-sensitive S. aureus


Panton-Valentine-Leukocidine gene


very low birth weight


neonatal intensive care units


nosocomially acquired MRSA


birth weight


gestational age


prolonged rupture of membranes


respiratory distress syndrome


broncho-pulmonary dysplasia


intraventricular hemorrhage


periventricular leukomalacia


necrotizing enterocolitis


retinopathy of prematurity


tryptic soy agar


chain reaction


ventricular septal defect


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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