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Colonization pattern of coagulase-negative staphylococci in preterm neonates and the relation to bacteremia

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Abstract

Coagulase-negative staphylococci (CoNS) are the major cause of sepsis in extreme preterm (EPT) newborns, but data on the CoNS colonization in EPT newborns prior to invasive infection are limited. Our aim was to describe the early establishment of the CoNS microflora in EPT newborns and to compare the colonization pattern in neonates with and without positive CoNS blood cultures. From a cohort of 46 EPT neonates, newborns with positive CoNS blood culture were identified (n = 10) and compared with matched controls. Samples for bacterial cultures were obtained repetitively from nares, perineum, and umbilicus. All CoNS isolates were characterized using the PhenePlate system for biochemical fingerprinting. Persistent CoNS strains were found on day 2–3 after delivery in 7/20 newborns, and there was a tendency for earlier colonization in nares than in the perineum or umbilicus. The CoNS blood strains were prevalent in superficial sites prior to positive blood culture (11/14 blood strains), but no single invasive pathway was identified. Most CoNS blood strains (9/14) persisted on superficial sites after antibiotic treatment. We hypothesize that the invasive pathways in neonatal CoNS sepsis are complex and that the colonization of mucosal membranes and umbilical catheters might be of equal importance.

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Abbreviations

CoNS:

Coagulase-negative staphylococci

EPT:

Extreme preterm

PFGE:

Pulsed-field gel electrophoresis

PhP:

PhenePlate system

MIC:

Minimum inhibitory concentration

UPGMA:

Unweighted pair grouping by mathematical averaging

Di :

Diversity index

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Acknowledgments

The authors wish to thank Bengt Hellmark for the rpoB sequencing. The study was supported by grants from the research committee of Örebro county.

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Authors and Affiliations

  1. Department of Pediatrics, Örebro University Hospital, 70185, Örebro, Sweden

    M. Björkqvist, M. Liljedahl & J. Schollin

  2. Department of Clinical Microbiology, Örebro University Hospital, 70185, Örebro, Sweden

    J. Zimmermann & B. Söderquist

Authors
  1. M. Björkqvist
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  2. M. Liljedahl
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  3. J. Zimmermann
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  4. J. Schollin
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  5. B. Söderquist
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Correspondence to M. Björkqvist.

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Financial support

Grants from the research committee of Örebro county, Sweden.

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Björkqvist, M., Liljedahl, M., Zimmermann, J. et al. Colonization pattern of coagulase-negative staphylococci in preterm neonates and the relation to bacteremia. Eur J Clin Microbiol Infect Dis 29, 1085–1093 (2010). https://doi.org/10.1007/s10096-010-0966-3

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  • DOI: https://doi.org/10.1007/s10096-010-0966-3

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