Kacica M A, Horgan M J, Preston K E, Lepow M, Venezia R A
Department of Pediatrics, Albany Medical College, NY.
Infect Control Hosp Epidemiol. 1994 Oct;15(10):658-62. doi: 10.1086/646829.
To investigate coagulase-negative staphylococcus (CONS) causing bacteremia in a neonatal intensive care unit (NICU).
A 14-month retrospective review of 47 infants in the NICU with CONS bacteremia was undertaken to determine CONS glycocalyx production, plasmid pattern, total DNA restriction fragment polymorphism, and clinical risk factors.
The isolates included 32 Staphylococcus epidermidis, six Staphylococcus haemolyticus, four Staphylococcus warneri, four Staphylococcus saprophyticus, and one Staphylococcus hominis. Sixty-five percent of S epidermidis produced glycocalyx; other species did not. Oxacillin resistance (52%) and the antibiograms of the CONS were consistent with other units in the hospital. Five similar CONS plasmid patterns were found among 16 isolates; 31 isolates had unique patterns. Extractions of total DNA from these isolates were digested using HindIII, HaeIII, and BstEII. Those with similar restriction fragment length patterns could not linked as nosocomially transmitted among infants with bacteremia.
Our observations suggest that multiple strains of CONS infect infants in the NICU who have similar risk factors. Although current infection control practices limit transmission of a pathogen, they do not prevent CONS bacteremias.
调查新生儿重症监护病房（NICU）中引起菌血症的凝固酶阴性葡萄球菌（CONS）。
对NICU中47例患有CONS菌血症的婴儿进行了为期14个月的回顾性研究，以确定CONS的糖萼产生情况、质粒图谱、总DNA限制性片段多态性以及临床危险因素。
分离出的菌株包括32株表皮葡萄球菌、6株溶血葡萄球菌、4株沃氏葡萄球菌、4株腐生葡萄球菌和1株人葡萄球菌。65%的表皮葡萄球菌产生糖萼；其他菌种则不产生。耐苯唑西林率（52%）以及CONS的抗菌谱与医院的其他科室一致。在16株分离菌中发现了5种相似的CONS质粒图谱；31株分离菌具有独特的图谱。使用HindIII、HaeIII和BstEII对这些分离菌的总DNA提取物进行消化。那些具有相似限制性片段长度图谱的菌株在患有菌血症的婴儿中不能被认定为医院内传播。
我们的观察结果表明，多种CONS菌株感染了NICU中具有相似危险因素的婴儿。尽管目前的感染控制措施限制了病原体的传播，但它们并不能预防CONS菌血症。
