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Glycopeptide use in NICU points toward need for improved strategies, screening to combat S. aureus
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The high usage of glycopeptides to treat methicillin-sensitive Staphylococcus aureus infections in one neonatal care unit could indicate needs to improve antimicrobial stewardship and introduce molecular screening to identify infections early, according to findings published in BMC Infectious Diseases.
“Reports from NICUs [have] show[n] that it is not easy to determine the incidence of MRSA infections,” the researchers wrote. “However, results from the present study, combining detailed epidemiological analyses with molecular studies of [S. aureus], allowed a much broader evaluation of these infections.”
Dorota Romaniszyn, chair of microbiology, Jagiellonian University Medical College, Kracow, Poland, and colleagues from other institutions conducted prospective surveillance of infections in the unit to characterize S. aureus in newborns for antibiotic resistance, virulence factors, genotypes, epidemiology and antibiotic consumption.
The investigators analyzed data about antibiotic treatment, assessed antimicrobial susceptibility and used polymerase chain reaction amplification to detect resistance and virulence genes. The researchers implemented typing methods including pulsed field gel electrophoresis, spa-sequencing and staphylococcal cassette chromosome mec.
S. aureus was associated with 6.5% of infections, and MRSA accounted for 32.8% of S. aureus infections. Overall, MRSA infections were seen in 1.1 of 1,000 newborns; MRSA infections were diagnosed earlier than methicillin-sensitive S. aureus (MSSA) infections (day 14 vs. day 23, P = .0194).
The risk for death increased with MRSA infections. Antibiotic usage in the MRSA and MSSA groups was similar; however, high glycopeptide use was observed for MSSA infections.
More strains were resistant to erythromycin, clindamycin, gentamicin and amikacin in the MRSA group vs. the MSSA group. Human leukocyte antigen was observed in 93.9% of strains, and staphylococcal enterotoxin genes in 65.3% of strains; a dominant clone was seen among the 14 MRSA isolates.
“Results obtained in the study point at [a] specific epidemiological situation in [the] Polish NICU,” the researchers wrote. “More detailed studies are recommended.” – by Allegra Tiver
Disclosure: The researchers report no relevant financial disclosures.
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