Nowrouzian Forough L, Lumingkit Kirth, Gio-Batta Monica, Jaén-Luchoro Daniel, Thordarson Thordur, Elfvin Anders, Wold Agnes E, Adlerberth Ingegerd
Institute of Biomedicine, Department of Infectious Diseases,The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Clinical Microbiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
Appl Environ Microbiol. 2025 Jan 31;91(1):e0098024. doi: 10.1128/aem.00980-24. Epub 2024 Dec 18.
Coagulase-negative staphylococci (CoNS) comprise about 50 species, some of which cause septicemia in preterm neonates. CoNS establish early on the skin and in the oral and gut microbiota, from where they may spread to the bloodstream. The colonization pattern preceding septicemia is not well-defined. Forty-two extremely preterm neonates (≤28 + 0 gestational weeks) were followed from birth to 2 months with regular sampling and culturing of the skin and oral and gut microbiota. Blood samples were drawn upon clinical suspicion of septicemia and cultured. CoNS species were identified using matrix-assisted laser-desorption ionization time of flight mass spectrometry (MALDI-TOF). Random amplified polymorphic DNA was used for strain typing, and strains were characterized regarding biofilm production and virulence gene carriage. CoNS blood isolates underwent whole genome sequencing. represented 72% of the CoNS isolates on skin or mucous membranes, followed by (13%) and (7%). CoNS septicemia was diagnosed in nine infants, yielding 11 septicemia isolates: seven . and four . of which nine were further analyzed. The septicemia isolates belonged to the NRCS-A clone. Two-thirds of the septicemia strains were traced back to the commensal microbiota. Colonization of the oral cavity by was significantly associated with CoNS septicemia development, although the blood-borne strains were more commonly found on the skin than in the mouth prior to invasion. Biofilm production was not associated with septicemia. Our results implicate CoNS colonization as a step that precedes septicemia in preterm neonates. Early colonization of the oral cavity by may represent a particular risk.
Septicemia is a major cause of morbidity in preterm infants. Coagulase-negative staphylococci (CoNS) can colonize skin, oral cavity, and intestines and are a common cause of septicemia in this group. The relation between CoNS colonization pattern at the species and strain level and septicemia has scarcely been studied. We mapped colonization of the skin, oral cavity, and intestines by CoNS species in extremely preterm infants and speciated and strain-typed the skin, mucosal, and blood isolates. Two-thirds of the CoNS septicemia blood strains, including a majority of strains belonging to the NRCS-A clone, were tracked to the commensal microbiota. We demonstrated that CoNS species differ in their colonization patterns, whereby was primarily a skin colonizer. However, its colonization of the oral cavity was enhanced among infants developing septicemia. Our study provides a starting point for further explorations of the relationship between CoNS colonization and septicemia in preterm infants.
凝固酶阴性葡萄球菌（CoNS）约有50个种，其中一些可导致早产儿败血症。CoNS早期定殖于皮肤以及口腔和肠道微生物群中，它们可能从这些部位扩散至血液中。败血症之前的定殖模式尚不明确。对42例极早产儿（孕周≤28 + 0周）从出生至2个月进行随访，定期对皮肤、口腔和肠道微生物群进行采样和培养。临床怀疑败血症时采集血样并进行培养。使用基质辅助激光解吸电离飞行时间质谱（MALDI - TOF）鉴定CoNS菌种。采用随机扩增多态性DNA进行菌株分型，并对菌株的生物膜形成和毒力基因携带情况进行表征。对CoNS血源分离株进行全基因组测序。 占皮肤或黏膜上CoNS分离株的72%，其次是 （13%）和 （7%）。9例婴儿被诊断为CoNS败血症，获得11株败血症分离株：7株 。 以及4株 ，其中9株进行了进一步分析。 败血症分离株属于NRCS - A克隆。三分之二的败血症菌株可追溯至共生微生物群。 定殖于口腔与CoNS败血症的发生显著相关，尽管在侵入之前血源 菌株在皮肤上比在口腔中更常见。生物膜形成与败血症无关。我们的结果表明CoNS定殖是早产儿败血症之前的一个步骤。 早期定殖于口腔可能代表一种特殊风险。
败血症是早产儿发病的主要原因。凝固酶阴性葡萄球菌（CoNS）可定殖于皮肤、口腔和肠道，是该群体败血症的常见病因。CoNS在菌种和菌株水平的定殖模式与败血症之间的关系鲜有研究。我们绘制了极早产儿中CoNS菌种在皮肤、口腔和肠道的定殖情况，并对皮肤、黏膜和血源分离株进行了菌种鉴定和菌株分型。三分之二的CoNS败血症血源菌株，包括大多数属于NRCS - A克隆的 菌株，可追溯至共生微生物群。我们证明CoNS菌种在定殖模式上存在差异，其中 主要是皮肤定殖菌。然而，在发生败血症的婴儿中其在口腔的定殖有所增加。我们的研究为进一步探索早产儿中CoNS定殖与败血症之间的关系提供了一个起点。
