Hand carriage, antimicrobial resistance and molecular characterisation of methicillin-resistant coagulase-negative staphylococci isolated from gynaecological surgical staff

Abstract

Sepsis caused by methicillin-resistant coagulase-negative staphylococci (MRCoNS) seriously affects the morbidity and mortality of neonates. However, the hand carriage and genotypic diversity of MRCoNS within surgical staff remain unclear in China. In the study, antimicrobial susceptibility tests and genotypic characterisation were applied to MRCoNS. One hundred and one samples were collected from the hands of gynaecological surgical staff. Eighty staphylococcal isolates were identified, of which 75 (94%) were resistant to at least one antibiotic. mecA gene was determined in 50 (62.5%) staphylococcal isolates. Panton–Valentine leukocidin (pvl) and ica genes were determined in 17 (21%) and 12 (15%) staphylococcal isolates, respectively. About 52% of staphylococci carried SCCmec IV and V, followed by SCCmec type I, II, and III (38%). In addition, two new STs types were assigned as ST844 and ST845. The high level of hand MRCoNS colonisation rate in gynaecological surgical staff is of concern, and hand hygiene management should be emphasised among surgical assistants. Impact statement What is already known on this subject? Coagulase-negative staphylococci (CoNS) are the predominant cause of neonatal sepsis. Exposure to antimicrobial-resistant CoNS might put neonates at increased risk of infection. However, little is known about the carriage and genetic diversity of methicillin-resistant CoNS (MRCoNS) of gynaecological surgeons and surgical assistants. What do the results of this study add? This is the first study on the molecular characterisation of MRCoNS recovered from gynaecological surgeons and surgical assistants in China. MRCoNS carriage rate in surgical assistants was significantly higher than in surgeons. Seventy-five (94%) coagulase-negative staphylococci were resistant to at least one antibiotic. SCCmec I, II and III was the dominant types identified in MRCoNS that were recovered from surgical staff. Fifty (62.5%) staphylococcal isolates that were recovered from surgical staff harboured the mecA gene. Pathogenic clones of MRCoNS were disseminated in surgical staff, and half of mecA-positive Staphylococcus epidermidis harboured the ica gene. What are the implications of these findings for clinical practice and/or further research? The high level of hand MRCoNS colonisation rate among gynaecological surgical staff is of concern. The alarming outcome of this study suggested that hygiene measures should be emphasised among gynaecological surgical assistants.