Prevalence of resistance to antiseptics and mupirocin among invasive coagulase-negative staphylococci from very preterm neonates in NICU: the creeping threat?

J Hosp Infect. 2013 Apr;83(4):333-6. doi: 10.1016/j.jhin.2012.11.025. Epub 2013 Feb 13.

Abstract

In neonatal intensive care units, topical agents represent an increasing part of the infection control armamentarium. Fifty-one coagulase-negative staphylococci (CNS) isolated from catheter-associated bloodstream infections in very preterm neonates were investigated in this study: 41.2% exhibited decreased susceptibility to at least one antiseptic (chlorhexidine 12%, benzalkonium 24%, acriflavine 33%) and 61% were resistant to mupirocin. QacA/B, mupA and both genes were detected by polymerase chain reaction in 59%, 63% and 49% of CNS, respectively. Seventy-six percent of Staphylococcus epidermidis (5/5 pulsed-field-gel electrophoresis subgroups) and 11% of Staphylococcus capitis (1/3 subgroups) were multi-resistant. Skin antisepsis using low-concentration aqueous formulations and off-label mupirocin indications should benefit from a stewardship programme.

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Anti-Infective Agents, Local / pharmacology*
  • Bacteremia / epidemiology
  • Bacteremia / microbiology
  • Catheter-Related Infections / epidemiology
  • Catheter-Related Infections / microbiology
  • DNA, Bacterial / genetics
  • Drug Resistance, Bacterial*
  • Female
  • Humans
  • Infant, Extremely Premature*
  • Infant, Newborn
  • Intensive Care Units, Neonatal
  • Male
  • Mupirocin / pharmacology*
  • Polymerase Chain Reaction
  • Staphylococcal Infections / epidemiology*
  • Staphylococcal Infections / microbiology
  • Staphylococcus / drug effects*
  • Staphylococcus / genetics
  • Staphylococcus / isolation & purification

Substances

  • Anti-Bacterial Agents
  • Anti-Infective Agents, Local
  • DNA, Bacterial
  • Mupirocin