Department of Pediatrics, Orebro University Hospital, Orebro, Sweden.
Eur J Clin Microbiol Infect Dis. 2010 Sep;29(9):1085-93. doi: 10.1007/s10096-010-0966-3. Epub 2010 Jun 2.
Coagulase-negative staphylococci (CoNS) are the major cause of sepsis in extreme preterm (EPT) newborns, but data on the CoNS colonization in EPT newborns prior to invasive infection are limited. Our aim was to describe the early establishment of the CoNS microflora in EPT newborns and to compare the colonization pattern in neonates with and without positive CoNS blood cultures. From a cohort of 46 EPT neonates, newborns with positive CoNS blood culture were identified (n = 10) and compared with matched controls. Samples for bacterial cultures were obtained repetitively from nares, perineum, and umbilicus. All CoNS isolates were characterized using the PhenePlate system for biochemical fingerprinting. Persistent CoNS strains were found on day 2-3 after delivery in 7/20 newborns, and there was a tendency for earlier colonization in nares than in the perineum or umbilicus. The CoNS blood strains were prevalent in superficial sites prior to positive blood culture (11/14 blood strains), but no single invasive pathway was identified. Most CoNS blood strains (9/14) persisted on superficial sites after antibiotic treatment. We hypothesize that the invasive pathways in neonatal CoNS sepsis are complex and that the colonization of mucosal membranes and umbilical catheters might be of equal importance.
凝固酶阴性葡萄球菌（CoNS）是极早产儿（EPT）新生儿败血症的主要原因，但关于 EPT 新生儿在侵袭性感染前 CoNS 定植的数据有限。我们的目的是描述 EPT 新生儿中 CoNS 微生物区系的早期建立，并比较有和没有 CoNS 阳性血培养的新生儿的定植模式。从 46 例 EPT 新生儿队列中，确定了 CoNS 阳性血培养的新生儿（n=10）并与匹配的对照组进行比较。从鼻腔、会阴和脐部重复采集样本进行细菌培养。使用 PhennePlate 系统对所有 CoNS 分离株进行生化指纹分析。在 20 名新生儿中有 7 名在分娩后第 2-3 天发现持续存在 CoNS 菌株，鼻腔定植的趋势早于会阴或脐带。CoNS 血菌株在血培养阳性前就已存在于浅表部位（14 株血菌株中有 11 株），但未确定单一的侵袭途径。大多数 CoNS 血菌株（14 株中的 9 株）在抗生素治疗后仍存在于浅表部位。我们假设新生儿 CoNS 败血症的侵袭途径复杂，黏膜定植和脐导管定植可能同样重要。
