PMID- 31789588
OWN - NLM
STAT- MEDLINE
DCOM- 20200207
LR  - 20200207
IS  - 1473-5644 (Electronic)
IS  - 0022-2615 (Linking)
VI  - 69
IP  - 1
DP  - 2020 Jan
TI  - Methicillin-resistant Staphylococcus epidermidis isolates with reduced vancomycin 
      susceptibility from bloodstream infections in a neonatal intensive care unit.
PG  - 41-45
LID - 10.1099/jmm.0.001117 [doi]
AB  - Introduction. Vancomycin has become the first-line therapy for most infections 
      caused by methicillin-resistant staphylococci.Aim. To evaluate the vancomycin 
      MIC, staphylococcal cassette chromosome mec (SCCmec) types and clonality of 
      coagulase-negative staphylococci (CoNS) isolates recovered from neonates with 
      true primary bloodstream infections (BSI).Methodology. CoNS isolates were 
      prospectively recovered from blood cultures of non-repetitive patients admitted 
      to a neonatal intensive care unit (NICU) in a tertiary-care hospital during a 
      3-year period. BSI was defined based on established criteria. Micro-organisms 
      were identified phenotypically and by PCR. MIC-values for vancomycin and 
      oxacillin were determined by broth dilution method and E-test. The SCCmec type 
      conferring methicillin resistance was determined by multiplex PCR. The 
      heterogeneous vancomycin (hV) resistance phenotype was screened on brain heart 
      infusion agar containing 4 microg ml(-1) of vancomycin. The clonality was 
      investigated by PFGE.Results. Seventy-four CoNS isolates were recovered from 
      blood cultures of neonates during the study period but only 40 (54 %) were 
      associated with true primary BSI. Nine (22.5%) babies died. Staphylococcus 
      epidermidis was the most prevalent species (95 %; 38/40). All S. epidermidis 
      isolates were methicillin-resistant (MR). SCCmec type IV was predominant (55.3 %; 
      21/38). Most (80.0 %; 32/38) isolates exhibited vancomycin MIC-values of 2-4 microg 
      ml(-1) not associated with the SCCmec type or clonality. Sixteen (42.1%) isolates 
      displayed hV resistance. All babies who died were harbouring MR-S. epidermidis 
      exhibiting vancomycin MICs of 2-4 microg ml(-1).Conclusion. The findings of this 
      study demonstrated that blood invasive MR-S. epidermidis isolates recovered at 
      NICU tend to show decreased vancomycin susceptibility making therapy of those 
      fragile patients difficult.
FAU - Peixoto, Patricia Borges
AU  - Peixoto PB
AD  - Instituto de Ciencias Biologicas e Naturais, Universidade Federal do Triangulo 
      Mineiro, Uberaba, Minas Gerais, Brazil.
FAU - Massinhani, Fernando Henrique
AU  - Massinhani FH
AD  - Instituto de Ciencias Biologicas e Naturais, Universidade Federal do Triangulo 
      Mineiro, Uberaba, Minas Gerais, Brazil.
FAU - Netto Dos Santos, Katia Regina
AU  - Netto Dos Santos KR
AD  - Instituto de Microbiologia Paulo de Goes, Universidade Federal do Rio de Janeiro, 
      Rio de Janeiro, Brazil.
FAU - Chamon, Raiane Cardoso
AU  - Chamon RC
AD  - Departamento de Patologia, Faculdade de Medicina, Universidade Federal 
      Fluminense, Niteroi, Rio de Janeiro, Brazil.
AD  - Instituto de Microbiologia Paulo de Goes, Universidade Federal do Rio de Janeiro, 
      Rio de Janeiro, Brazil.
FAU - Silva, Renata Beatriz
AU  - Silva RB
AD  - Instituto de Ciencias Biologicas e Naturais, Universidade Federal do Triangulo 
      Mineiro, Uberaba, Minas Gerais, Brazil.
FAU - Lopes Correa, Fabio Ederson
AU  - Lopes Correa FE
AD  - Instituto de Ciencias Biologicas e Naturais, Universidade Federal do Triangulo 
      Mineiro, Uberaba, Minas Gerais, Brazil.
FAU - Barata Oliveira, Cristina da Cunha Hueb
AU  - Barata Oliveira CDCH
AD  - Instituto de Ciencias da Saude, Universidade Federal do Triangulo Mineiro, 
      Uberaba, Minas Gerais, Brazil.
FAU - Oliveira, Adriana Goncalves
AU  - Oliveira AG
AD  - Instituto de Ciencias Biologicas e Naturais, Universidade Federal do Triangulo 
      Mineiro, Uberaba, Minas Gerais, Brazil.
LA  - eng
PT  - Journal Article
PL  - England
TA  - J Med Microbiol
JT  - Journal of medical microbiology
JID - 0224131
RN  - 0 (Anti-Bacterial Agents)
RN  - 6Q205EH1VU (Vancomycin)
RN  - Q91FH1328A (Methicillin)
SB  - IM
MH  - Anti-Bacterial Agents/pharmacology
MH  - Bacteremia/drug therapy
MH  - Disease Susceptibility
MH  - Drug Resistance, Bacterial/genetics
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Intensive Care Units, Neonatal
MH  - Intensive Care, Neonatal
MH  - Methicillin/*pharmacology
MH  - Methicillin Resistance/*genetics
MH  - Methicillin-Resistant Staphylococcus aureus/drug effects
MH  - Microbial Sensitivity Tests
MH  - Sepsis/drug therapy
MH  - Staphylococcal Infections/drug therapy
MH  - Staphylococcus/drug effects/isolation & purification
MH  - Staphylococcus epidermidis/*drug effects/isolation & purification/metabolism
MH  - Vancomycin/pharmacology
MH  - Vancomycin Resistance/genetics
OTO - NOTNLM
OT  - SCCmec
OT  - coagulase-negative staphylococci
OT  - neonate
OT  - sepsis
OT  - vancomycin heteroresistance
EDAT- 2019/12/04 06:00
MHDA- 2020/02/08 06:00
CRDT- 2019/12/03 06:00
PHST- 2019/12/04 06:00 [pubmed]
PHST- 2020/02/08 06:00 [medline]
PHST- 2019/12/03 06:00 [entrez]
AID - 10.1099/jmm.0.001117 [doi]
PST - ppublish
SO  - J Med Microbiol. 2020 Jan;69(1):41-45. doi: 10.1099/jmm.0.001117.