Abstract
Background: There are only a few reports in the literature about translocation of coagulase-negative staphylococci (CoNS) as a primary cause of sepsis in neonates, although CoNS are among a short list of “translocating” bacteria when present in abundance. Methods: 468 blood samples, 119 stool samples, and 8 catheter tips, from 311 neonates, were tested for presence of microorganisms. CoNS strains isolated from the blood and stool or from blood and catheter tip of the same newborn at approximately the same time were paired and typed with PFGE (Pulse-Field Gel Electrophoresis) method. The strains were then tested for the presence of adherence genes and biofilm formation. Results: The strains with identical PFGE profiles in comparison to those with non-identical profiles differed in terms of the pattern of the virulence genes and showed a lack of the genes related to adherence, but more often presence of IS256, which is related to virulence. They also were phenotypically unable to adhere to intestinal Caco2 cells. Conclusions: A considerable proportion of CoNS strains isolated from bloodstream of VLBW/LWB neonates was identical to the strains isolated from faeces of the same neonates at the same time. These observations may offer indirect evidence indicating that at least some CoNS can translocate from the gastrointestinal tract of the premature neonates into the bloodstream and thus cause generalized infection.
Highlights
Sepsis in low-birth-weight (LBW) and very low-birth-weight (VLBW) neonates is still one of the most significant causes of neonatal morbidity and mortality
Among coagulasenegative staphylococci (CoNS) strains, these belonging to S. epidermidis species predominated over S. haemolyticus, S. capitis, and S. hominis; only a few strains belonged to other species
One-quarter of CoNS strains isolated from bloodstream of VLBW/LWB neonates were identical to the strains isolated from faeces of the same neonates at the same time as demonstrated by Pulse-Field Gel Electrophoresis (PFGE) profiling
Summary
Sepsis in low-birth-weight (LBW) and very low-birth-weight (VLBW) neonates is still one of the most significant causes of neonatal morbidity and mortality. Results: The strains with identical PFGE profiles in comparison to those with non-identical profiles differed in terms of the pattern of the virulence genes and showed a lack of the genes related to adherence, but more often presence of IS256, which is related to virulence. Conclusions: A considerable proportion of CoNS strains isolated from bloodstream of VLBW/LWB neonates was identical to the strains isolated from faeces of the same neonates at the same time. These observations may offer indirect evidence indicating that at least some CoNS can translocate from the gastrointestinal tract of the premature neonates into the bloodstream and cause generalized infection
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