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凝固酶阴性葡萄球菌在新生儿血培养中的表型特征分析,重点关注头状葡萄球菌。

Phenotypic characterisation of coagulase-negative staphylococci isolated from blood cultures in newborn infants, with a special focus on Staphylococcus capitis.

机构信息

School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.

Department of Laboratory Medicine, Clinical Microbiology, Örebro University Hospital, Örebro, Sweden.

出版信息

Acta Paediatr. 2017 Oct;106(10):1576-1582. doi: 10.1111/apa.13950. Epub 2017 Jul 10.

Abstract

AIM

This Swedish study determined which species of coagulase-negative staphylococci (CoNS) were found in neonatal blood cultures and whether they included Staphylococcus capitis clones with decreased susceptibility to vancomycin.

METHODS

CoNS isolates (n = 332) from neonatal blood cultures collected at Örebro University Hospital during 1987-2014 were identified to species level with matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF MS). The antibiotic susceptibility pattern of S. capitis isolates was determined by the disc diffusion test and Etest, and the presence of heterogeneous glycopeptide-intermediate S. capitis (hGISC) was evaluated.

RESULTS

Staphylococcus epidermidis (67.4%), Staphylococcus haemolyticus (10.5%) and S. capitis (9.6%) were the most common CoNS species. Of the S. capitis isolates, 75% were methicillin-resistant and 44% were multidrug-resistant. No isolate showed decreased susceptibility to vancomycin, but at least 59% displayed the hGISC phenotype. Staphylococcus capitis isolates related to the strain CR01 displaying pulsotype NRCS-A were found.

CONCLUSION

Staphylococcus epidermidis, S. haemolyticus and S. capitis were the predominant species detected in neonatal blood cultures by MALDI-TOF MS. The number of episodes caused by S. capitis increased during the study period, but no isolates with decreased susceptibility to vancomycin were identified. However, S. capitis isolates related to the strain CR01 displaying pulsotype NRCS-A were found.

摘要

目的

本项瑞典研究旨在确定凝固酶阴性葡萄球菌(CoNS)中哪些菌种存在于新生儿血培养物中,以及它们是否包括对万古霉素敏感性降低的头状葡萄球菌克隆。

方法

1987 年至 2014 年,在厄勒布鲁大学医院采集的新生儿血培养物中,采用基质辅助激光解吸电离飞行时间质谱(MALDI-TOF MS)对头状葡萄球菌等 CoNS 分离株进行菌种鉴定。采用纸片扩散法和 Etest 法检测头状葡萄球菌分离株的药敏谱,并评估是否存在异质性糖肽中介头状葡萄球菌(hGISC)。

结果

表皮葡萄球菌(67.4%)、溶血葡萄球菌(10.5%)和头状葡萄球菌(9.6%)是最常见的 CoNS 菌种。在头状葡萄球菌分离株中,75%为耐甲氧西林金黄色葡萄球菌,44%为多重耐药菌。没有分离株对万古霉素显示出低敏感性,但至少有 59%显示出 hGISC 表型。发现与显示 NRCS-A 脉冲模式的 CR01 菌株相关的头状葡萄球菌分离株。

结论

MALDI-TOF MS 检测新生儿血培养物中,表皮葡萄球菌、溶血葡萄球菌和头状葡萄球菌是最主要的菌种。在研究期间,由头状葡萄球菌引起的感染病例数有所增加,但未发现对万古霉素敏感性降低的分离株。然而,发现与显示 NRCS-A 脉冲模式的 CR01 菌株相关的头状葡萄球菌分离株。

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