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

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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.

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Notes

  1. Place of insertion of Table 1.

  2. Place of insertion of Table 2.

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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Authors and Affiliations

  1. Neonatal Department, The Edmond and Lili Safra Children’s Hospital, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Jacob Kuint, Asher Barzilai, Gili Regev-Yochay, Ethan Rubinstein, Nati Keller & Ayala Maayan-Metzger

  2. Department of Neonatology, Sheba Medical Center, 52621, Tel Aviv, Israel

    Jacob Kuint

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  1. Jacob Kuint
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  2. Asher Barzilai
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  5. Nati Keller
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Correspondence to Jacob Kuint.

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Kuint, J., Barzilai, A., Regev-Yochay, G. et al. Comparison of community-acquired methicillin-resistant Staphylococcus aureus bacteremia to other staphylococcal species in a neonatal intensive care unit. Eur J Pediatr 166, 319–325 (2007). https://doi.org/10.1007/s00431-006-0238-5

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  • DOI: https://doi.org/10.1007/s00431-006-0238-5

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