Berends Matthijs S, Luz Christian F, Ott Alewijn, Andriesse Gunnar I, Becker Karsten, Glasner Corinna, Friedrich Alex W
Certe Foundation, 9713 AV Groningen, The Netherlands.
Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands.
Microorganisms. 2022 Sep 7;10(9):1801. doi: 10.3390/microorganisms10091801.
For years, coagulase-negative staphylococci (CoNS) were not considered a cause of bloodstream infections (BSIs) and were often regarded as contamination. However, the association of CoNS with nosocomial infections is increasingly recognized. The identification of more than 40 different CoNS species has been driven by the introduction of matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry. Yet, treatment guidelines consider CoNS as a whole group, despite increasing antibiotic resistance (ABR) in CoNS. This retrospective study provides an in-depth data analysis of CoNS isolates found in human blood culture isolates between 2013 and 2019 in the entire region of the Northern Netherlands.
In total, 10,796 patients were included that were hospitalized in one of the 15 hospitals in the region, leading to 14,992 CoNS isolates for (ABR) data analysis. CoNS accounted for 27.6% of all available 71,632 blood culture isolates. EUCAST Expert rules were applied to correct for errors in antibiotic test results.
A total of 27 different CoNS species were found. Major differences were observed in occurrence and ABR profiles. The top five species covered 97.1% of all included isolates: , , , and . Regarding ABR, methicillin resistance was most frequently detected in (72%), (65%), and (62%). and showed 50-80% resistance to teicoplanin and macrolides while resistance to these agents remained lower than 10% in most other CoNS species.
These differences are often neglected in national guideline development, prompting a focus on 'ABR-safe' agents such as glycopeptides. In conclusion, this multi-year, full-region approach to extensively assess the trends in both the occurrence and phenotypic resistance of CoNS species could be used for evaluating treatment policies and understanding more about these important but still too often neglected pathogens.
多年来，凝固酶阴性葡萄球菌（CoNS）未被视为血流感染（BSI）的病因，常被视为污染菌。然而，CoNS与医院感染的关联日益受到认可。基质辅助激光解吸/电离飞行时间（MALDI-TOF）质谱技术的引入推动了40多种不同CoNS菌种的鉴定。尽管CoNS的抗生素耐药性（ABR）不断增加，但治疗指南仍将CoNS视为一个整体。这项回顾性研究对2013年至2019年荷兰北部整个地区人类血培养分离株中发现的CoNS分离株进行了深入的数据分析。
共纳入该地区15家医院之一住院的10796例患者，得到14992株CoNS分离株用于（ABR）数据分析。CoNS占所有71632份可用血培养分离株的27.6%。采用欧盟CAST专家规则校正抗生素检测结果中的误差。
共发现27种不同的CoNS菌种。在发生率和ABR谱方面观察到主要差异。前五种菌种占所有纳入分离株的97.1%： 、 、 、 和 。关于ABR，在 （72%）、 （65%）和 （62%）中最常检测到耐甲氧西林。 和 对替考拉宁和大环内酯类药物表现出50-80%的耐药性，而在大多数其他CoNS菌种中对这些药物的耐药性仍低于10%。
这些差异在国家指南制定中常常被忽视，促使人们关注糖肽类等“ABR安全”药物。总之，这种多年、全地区广泛评估CoNS菌种发生率和表型耐药性趋势的方法可用于评估治疗策略，并更多地了解这些重要但仍常常被忽视的病原体。
