Centre International de Recherche en Infectiologie (CIRI), INSERM U1111, CNRS UMR5308, Ecole Normale Supérieure de Lyon, Université Claude Bernard Lyon 1, 46 Allée d'Italie 69364 Lyon Cedex 07, France; Centre National de Référence des Staphylocoques, Hospices Civils de Lyon, 103 Grande Rue de La Croix Rousse, 69004 Lyon, France; Département de Microbiologie et Mycologie, Institut des Sciences Pharmaceutiques et Biologiques de Lyon, Université de Lyon, 6 Avenue Rockefeller, 69008 Lyon, France.
Centre International de Recherche en Infectiologie (CIRI), INSERM U1111, CNRS UMR5308, Ecole Normale Supérieure de Lyon, Université Claude Bernard Lyon 1, 46 Allée d'Italie 69364 Lyon Cedex 07, France; Réanimation Néonatale, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 59 Bd Pinel 69500 Bron, France.
Clin Microbiol Infect. 2019 Sep;25(9):1081-1085. doi: 10.1016/j.cmi.2019.03.009. Epub 2019 Mar 27.
In neonatal intensive care units (NICUs), nosocomial late-onset sepsis (LOS), mostly due to coagulase negative staphylococci, constitute a major cause of death or impairment. Staphylococcus capitis, usually considered as a poorly virulent species, has been reported as a cause of LOS.
To review data regarding S. capitis neonatal LOS and the features of isolates involved.
PubMed was searched up to August 2018 to retrieve studies on the topic; the keywords used were 'S. capitis', 'neonate', 'neonatal ICU', 'bloodstream infection' and 'late onset sepsis'.
Published data highlight the worldwide endemicity of a single S. capitis clone, named NRCS-A, specifically involved in LOS. NRCS-A harbours a multidrug resistance profile (including resistance to the usual first-line antibiotics used in NICUs). It is also able to adapt under vancomycin selective pressure that could confer an advantage for its implantation and dissemination in NICUs where this selective pressure is high. Moreover, a severe morbidity has been observed in NRCS-A-related LOS. The NICU environment, and especially incubators, constitute reservoirs of NRCS-A from which it could diffuse inside the setting. Finally, the virulome and resistome of S. capitis NRCS-A contain many genes potentially implicated in its specific epidemiology and pathophysiology, including the gene nsr that may be involved in its fitness and implantation in neonatal gut flora.
S. capitis must be considered as a true pathogen in neonates. The decreased susceptibility to vancomycin may be involved in failure of vancomycin therapy. Further studies are needed to better manage its diffusion inside each NICU but also worldwide.
在新生儿重症监护病房（NICU）中，凝固酶阴性葡萄球菌引起的医院获得性晚发性败血症（LOS）是导致死亡或发病的主要原因。表皮葡萄球菌通常被认为是一种毒力较弱的细菌，但也有报道称其可引起 LOS。
综述关于表皮葡萄球菌新生儿 LOS 的数据，并探讨其分离株的特征。
检索截至 2018 年 8 月的 PubMed 数据库，检索主题相关的研究，使用的关键词为“S. capitis”“neonate”“neonatal ICU”“bloodstream infection”和“late onset sepsis”。
已发表的数据强调了一种名为 NRCS-A 的表皮葡萄球菌单克隆株在全球流行，这种单克隆株与 LOS 密切相关。NRCS-A 具有多重耐药表型（包括对 NICU 中常用的一线抗生素的耐药性）。它还能适应万古霉素的选择压力，这可能使其在选择压力较高的 NICU 中定植和传播具有优势。此外，在与 NRCS-A 相关的 LOS 中观察到严重的发病率。NICU 环境，特别是培养箱，是 NRCS-A 的储存库，它可以从这里扩散到 NICU 内部。最后，表皮葡萄球菌 NRCS-A 的毒力组和耐药组包含许多可能与其特定流行病学和发病机制相关的基因，包括可能与 NSR 定植和新生儿肠道菌群定植相关的基因。
表皮葡萄球菌必须被视为新生儿的真正病原体。对万古霉素的敏感性降低可能与万古霉素治疗失败有关。需要进一步研究以更好地管理其在每个 NICU 内部以及全球范围内的传播。
