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Prevalence and Clinical Relevance of Staphylococcus warneri in the Neonatal Intensive Care Unit

Published online by Cambridge University Press:  02 January 2015

Jeannie P. Cimiotti
Affiliation:
Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia
Janet P. Haas
Affiliation:
School of Nursing, New York, New York
Phyllis Della-Latta
Affiliation:
Department of Pathology, New York, New York
Fann Wu
Affiliation:
Department of Pathology, New York, New York
Lisa Saiman
Affiliation:
Department of Pediatrics, Columbia University, New York, New York Department of Epidemiology, Columbia University Medical Center, Columbia University, New York, New York New York-Presbyterian Hospital, New York, New York
Elaine L. Larson
Affiliation:
School of Nursing, New York, New York
Corresponding

Abstract

Objective.

To describe the prevalence of Staphylococcus warneri on the hands of nurses and the clinical relevance of this organism among neonates in the neonatal intensive care unit (NICU).

Design.

Prospective cohort study that examined the microbial flora on the hands of nurses and clinical isolates recovered from neonates during a 23-month period (March 1, 2001, through January 31, 2003).

Setting.

Two high-risk NICUs in New York City.

Participants.

All neonates hospitalized in the NICUs for more than 24 hours and all full-time nurses from the same NICUs who volunteered to participate.

Intervention.

At baseline and then every 3 months, samples for culture were obtained from each nurse's cleaned dominant hand. Pulsed-field electrophoresis compared S. warneri isolates from neonates and staff.

Results.

Samples for culture (n = 834) were obtained from the hands of 119 nurses; 520 (44%) of the 1,195 isolates of coagulase-negative staphylococci recovered were identified as S. warneri. Of the 647 clinically relevant isolates recovered from neonates, 17 (8%) of the 202 isolates that were identified to species level were S. warneri. Pulsed-field electrophoresis revealed a common strain of S. warneri that was shared among the nurses and neonates. Furthermore, 117 (23%) of 520 S. warneri isolates from nurses' hands had minimum inhibitory concentrations for vancomycin of 4 μg/mL, which indicate decreasing susceptibility.

Conclusions.

Our findings that S. warneri can be pathogenic in neonates, is a predominant species of coagulase-negative staphylococci cultured from the hands of nurses, and has decreased vancomycin susceptibility underscore the importance of continued surveillance for vancomycin resistance and pathogenicity in pediatric care settings.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007

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References

1.Gaynes, RP, Edwards, JR, Jarvis, WR, Culver, DH, Toison, JS, Martone, WJ. Nosocomial infections among neonates in high-risk nurseries in the United States: National Nosocomial Infections Surveillance System. Pediatrics 1996;98:357361.Google Scholar
2.Grohskopf, LA, Sinkowitz-Cochran, RL, Garrett, DO, et al. A national point-prevalence survey of pediatric intensive care unit-acquired infections in the United States. J Pediatr 2002;140:432438.CrossRefGoogle ScholarPubMed
3.Fallat, ME, Gallinero, RN, Stover, BH, Wilkerson, S, Goldsmith, LJ. Central venous catheter bloodstream infections in the neonatal intensive care unit. J Pediatr Surg 1998;33:13831387.CrossRefGoogle ScholarPubMed
4.Raimundo, O, Heussler, H, Bruhn, JB, et al. Molecular epidemiology of coagulase-negative staphylococcal bacteraemia in a newborn intensive care unit. J Hosp Infect 2002;51:3342.CrossRefGoogle Scholar
5.Udo, EE, Jacob, LE, Chugh, TD. Antimicrobial resistance of coagulase-negative staphylococci from a Kuwait hospital. Microb Drug Resist 1995;1:315320.CrossRefGoogle ScholarPubMed
6.Larson, EL, Hughes, CA, Pyrek, JD, Sparks, SM, Cagatay, EU, Bartkus, JM. Changes in bacterial flora associated with skin damage on hands of health care personnel. Am J Infect Control 1998;26:513521.CrossRefGoogle Scholar
7.Horn, WA, Larson, EL, McGinley, KJ, Leyden, JJ. Microbial flora on the hands of health care personnel: differences in composition and antibacterial resistance. Infect Control Hosp Epidemiol 1988;9:189193.CrossRefGoogle Scholar
8.Gupta, A, Della-Latta, P, Todd, B, et al. Outbreak of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in a neonatal intensive care unit linked to artificial nails. Infect Control Hosp Epidemiol 2004;25:210215.CrossRefGoogle Scholar
9.Huang, YC, Lin, TY, Leu, HS, Peng, HL, Wu, JH, Chang, HY. Outbreak of Candida parapsilosis fungemia in neonatal intensive care units: clinical implications and genotyping analysis. Infection 1999;27:97102.CrossRefGoogle ScholarPubMed
10.Foca, M, Jakob, K, Whitter, S, et al. Endemic Pseudomonas aeruginosa infection in a neonatal intensive care unit. N Engl J Med 2000;343:695700.CrossRefGoogle Scholar
11.Diekema, DJ, Pfaller, MA, Schmitz, FJ, et al. Survey of infections due to Staphylococcus species: frequency of occurrence and antimicrobial susceptibility of isolates collected in the United Status, Canada, Latin America, Europe, and the western Pacific region for the SENTRY Antimicrobial Surveillance Program, 1997-1999. Clin Infect Dis 2001;32(Suppl 2):S114S132.CrossRefGoogle Scholar
12.Tacconelli, E, Tumbarello, M, de Gaetano Donati, K, et al. Glycopeptide resistance among coagulase-negative staphylococci that cause bacteremia: epidemiological and clinical findings from a case-control study. Clin Infect Dis 2001;33:16281635.CrossRefGoogle ScholarPubMed
13.Larson, EL, Cimiotti, J, Haas, J, et al. Effect of antiseptic handwashing vs alcohol sanitizer on health care-associated infections in neonatal intensive care units. Arch Pediatr Adolesc Med 2005;159:377383.CrossRefGoogle ScholarPubMed
14.Horan, TC, Emori, TG. Definitions of key terms used in the NNIS System. Am J Infect Control 1997;25:112116.CrossRefGoogle ScholarPubMed
15.Larson, E, Silberger, M, Jakob, K, et al. Assessment of alternative hand hygiene regimens to improve skin health among neonatal intensive care unit nurses. Heart Lung 2000;29:136142.CrossRefGoogle ScholarPubMed
16.Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Testing. 15th informational supplement. Wayne, PA: Clinical and Laboratory Standards Institute, 2005::111113.Google Scholar
17.Olive, DM, Bean, P. Principles and applications of methods for DNA-based typing of microbial organisms. J Clin Microbiol 1999;37:16611669.Google ScholarPubMed
18.Tenover, FC, Arbeit, RD, Goering, RV, et al. Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 1995;33:22332239.Google ScholarPubMed
19.Mehr, SS, Sadowsky, JL, Doyle, LW, Carr, J. Sepsis in neonatal intensive care in the late 1990s. J Paediatr Child Health 2002;38:246251.CrossRefGoogle ScholarPubMed
20.Buttery, JP, Easton, M, Pearson, SR, Hogg, GG. Pediatric bacteremia due to Staphylococcus warneri: microbiological, epidemiological, and clinical features. J Clin Microbiol 1997;35:21742177.Google ScholarPubMed
21.Kacica, MA, Horgan, MJ, Preston, KE, Lepow, M, Venezia, RA. Relatedness of coagulase-negative staphylococci causing bacteremia in low-birth-weight infants. Infect Control Hosp Epidemiol 1994;15:658662.CrossRefGoogle Scholar
22.Lee, YL, Cesario, T, Lee, R, et al. Colonization by Staphylococcus species resistant to methicillin or quinolone on hands of medical personnel in a skilled-nursing facility. Am J Infect Control 1994;22:346351.CrossRefGoogle Scholar
23.Perdreau-Remington, F, Stefanik, D, Peters, G, et al. Methicillin-resistant Staphylococcus haemolyticus on the hands of health care workers: a route of transmission or a source? J Hosp Infect 1995;31:195203.CrossRefGoogle ScholarPubMed
24.Kloos, WE, Musselwhite, MS. Distribution and persistence of Staphylococcus and Micrococcus species and other aerobic bacteria on human skin. Appi Microbiol 1975;30:381385.Google ScholarPubMed
25.Patrick, CH, John, JF, Levkoff, AH, Atkins, LM. Relatedness of strains of methicillin-resistant coagulase-negative Staphylococcus colonizing hospital personnel and producing bacteremias in a neonatal intensive care unit. Pediatr Infect Dis 1992;11:935940.CrossRefGoogle Scholar
26.Klingenberg, C, Glad, GT, Olsvik, R, Flaegstad, T. Rapid PCR detection of the methicillin resistance gene, mecA, on the hands of medical and nonmedical personnel and healthy children and on surfaces in a neonatal intensive care unit. Scand J Infect Dis 2001;33:494497.Google Scholar
27.Milisavljevic, V, Wu, F, Cimiotti, J, Haas, J, Della-Latta, P, Larson, E, Saiman, L. Genetic relatedness of Staphylococcus epidermidis from infected infants and staff in the neonatal intensive care unit. Am J Infect Control 2005;33:34147.CrossRefGoogle Scholar
28.Cimiotti, JP, Wu, F, Della-Latta, P, Nesin, M, Larson, EL. Emergence of resistant staphylococci on the hands of new graduate nurses. Infect Control Hosp Epidemiol 2004;25:431435.CrossRefGoogle ScholarPubMed
29.Center, KJ, Reboli, AC, Hubler, R, Rodgers, GL, Long, SS. Decreased vancomycin susceptibility of coagulase-negative staphylococci in a neonatal intensive care unit: evidence of spread of Staphylococcus warneri. J Clin Microbiol 2003;41:46604665.CrossRefGoogle Scholar
30.Cohen, B, Saiman, L, Cimiotti, J, Larson, E. Factors associated with hand hygiene practices in two neonatal intensive care units. Pediatr Infect Dis J 2003;22:494499.CrossRefGoogle ScholarPubMed
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