Abstract
Coagulase-negative staphylococci (CoNS) are the most common isolates from blood culture in neonates resulting in high mortality and morbidity. This study investigated CoNS obtained from blood cultures of neonates for antibiotic resistance and virulence factors, and possible association with inflammatory response (C-reactive protein). A total of 93 CoNS isolates were collected from 76 blood cultures of neonates at the Maternity hospital in Kuwait in a six-month period and investigated for susceptibility to antibiotics, carriage of staphylococcal cassette chromosome mec (SCCmec), and virulence-associated genes. The 93 CoNS isolates consisted of S. epidermidis (76; 81.7%), S. capitis (12; 12.9%), S. hominis (2; 2.1%), S. warneri (2; 2.1%) and S. haemolyticus (1; 1.0%). Eighty-six (92.4%) of the isolates were resistant to cefoxitin (MR-CoNS) while 49 (52.7%) expressed multi-antibiotic resistance. The methicillin-resistant isolates (MR-CoNS) carried SCCmec III, SCCmec IVa and four combinations of SCCmec types including SCCmec types I+IVa (one S. warneri and 25 S. epidermidis isolates), types I+III (one S. epidermidis isolate), types III+IVa (six S. epidermidis isolates) and types I+III+IVa (one S. epidermidis isolate). The most common virulence-related genes were icaC, seb, arc detected in 69.7%, 60.5%, 40.8% of the isolates respectively. Two isolates were positive for tst1. No association between C-reactive protein and antibiotic resistance or virulence factors was established. This study revealed that S. epidermidis carrying different SCCmec genetic elements, was the dominant CoNS species isolated from neonatal blood cultures with 90.3% and 36.6% of the isolates positive for genes for biofilm and ACME production respectively.
Highlights
Neonatal sepsis is a fatal infection that appears in the first 28 days of a neonate’s life or up to 4 weeks after the expected due date for preterm infants [1]
coagulase-negative staphylococci (CoNS) obtained from blood cultures of neonates admitted to the Maternity hospital in Kuwait were investigated for antibiotic resistance, biofilm formation, and the carriage of other virulence determinants
This study investigated CoNS isolated from blood cultures of neonates for antibiotic resistance and the carriage of genes for virulence including genes for biofilm formation, staphylococcal
Summary
Neonatal sepsis is a fatal infection that appears in the first 28 days of a neonate’s life or up to 4 weeks after the expected due date for preterm infants [1]. Studies have shown that CoNS causing late onset sepsis in neonates are often multiresistant to antibiotics [12]. The mecA gene, that encodes methicillin resistance, has been reported in as much as 80% of the CoNS isolates causing late-onset sepsis [13]. Based on the carriage of the arc, opp and kdp Antimicrobial resistance and virulence determinants in coagulase-negative staphylococci clusters, five ACME types have been identified [16, 19]. CoNS obtained from blood cultures of neonates admitted to the Maternity hospital in Kuwait were investigated for antibiotic resistance, biofilm formation, and the carriage of other virulence determinants. The possible correlation between inflammatory response (C-reactive protein) and carriage of virulence factors were investigated
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