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Prevalence, clonality, and pathogenicity of Staphylococcus epidermidis isolates in newborn feces

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European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

Coagulase-negative staphylococci (CoNS) are the most prevalent pathogens causing late-onset sepsis in neonates. The question is whether neonates acquire endemic hospital-adapted clones or incidentally occurring CoNS strains after birth during their hospital stay. Therefore, a prospective study was performed on the prevalence of CoNS in the stool of babies (born vaginally or by cesarean section) during their first days of life. Their clonal relatedness and potential to induce invasive disease were characterized. CoNS were analyzed from the stool samples of newborns with a load of CoNS above 103 colony-forming units (CFU)/mL. The identification of CoNS was performed phenotypically and genotypically. For typing, repetitive polymerase chain reaction (PCR), pulsed-field gel electrophoresis, and multilocus sequence typing were used. Resistance profiles, biofilm production, the presence of icaAD and of IS256 were determined as well. From a total of 207 stool samples (56 newborns), CoNS were detected in 41% of the newborns, mostly on day 3 for the first time (62.5%). Staphylococcus epidermidis was isolated in 85.7% of cases, harbored no IS256 element, and mostly expressed no biofilm. The isolates were separated into four main clusters by repetitive sequence-based PCR. 24% of the strains showed no antimicrobial resistance. 20% were resistant against four antibiotics of two different antibiotic classes. The remaining strains were resistant only against one antimicrobial substance class. Thus, it can be concluded that newborns do not acquire hospital-adapted endemic, multidrug-resistant S. epidermidis isolates during their first days of life. Yet, the results support the thesis that, during hospital stay, environmental parameters may convert sensible/noninvasive S. epidermidis strains into multidrug-resistant strains with characteristics of invasiveness.

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Acknowledgments

The authors wish to acknowledge Prof. Dr. h.c. SD Costa, Department of Obstetrics and Gynecology, University of Magdeburg, for support and for the assistance in data collection.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Clinic St. Hedwig, Hospital of the Barmherzige Brueder, University Medical Center Regensburg, Steinmetzstrasse 1–3, 93049, Regensburg, Germany

    S Fill Malfertheiner, M. Weigl & B. Seelbach-Göbel

  2. Institute of Medical Microbiology, University of Magdeburg, Leipziger Strasse 44, 39120, Magdeburg, Germany

    S. Wendt, W. König & B. König

  3. Robert Koch Institute (RKI), Burgstraße 37, 38855, Wernigerode, Germany

    F. Layer

  4. Institute of Medical Microbiology and Infectious Epidemiology, University of Leipzig, Liebigstrasse 18, 04103, Leipzig, Germany

    B. König

Authors
  1. S Fill Malfertheiner
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  2. S. Wendt
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  3. F. Layer
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  4. M. Weigl
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  5. B. Seelbach-Göbel
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  6. W. König
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  7. B. König
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Contributions

BK has made substantial contributions to the conception and design of the study, the sample collection, analysis, and statistical analysis and interpretation of the data. FL and SW participated in the sample collection, analysis, and interpretation of the data. SFM was involved in the data collection and drafting the manuscript. BS-G has critically revised the manuscript and added important intellectual content. WK has been substantially involved in the designing of the study. MW participated in the drafting of the manuscript and gave final approval of the version to be published. All authors read and approved the final manuscript.

Corresponding author

Correspondence to S Fill Malfertheiner.

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Data availability

The datasets analyzed during the current study are available from BK on reasonable request (Brigitte.Koenig@medizin.uni-leipzig.de).

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Fill Malfertheiner, S., Wendt, S., Layer, F. et al. Prevalence, clonality, and pathogenicity of Staphylococcus epidermidis isolates in newborn feces. Eur J Clin Microbiol Infect Dis 36, 1955–1964 (2017). https://doi.org/10.1007/s10096-017-3019-3

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  • DOI: https://doi.org/10.1007/s10096-017-3019-3

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