A Systematic Review of Coagulase-Negative Staphylococci in Neonatal Sepsis

Abstract

We sought to analyze the prevalence of neonatal sepsis based on eight selected articles published in 2016 and 2017 with details on the demographics, bacteria distribution, risk factors, antibacterial susceptibility and the rising isolation of Coagulase-negative Staphylococci (CoNS) among other bacteria isolates. Early Onset Neonatal Sepsis (EONS) was prevalent in most of the studies than Late-Onset Neonatal Sepsis (LONS). The rate of CoNS isolation in neonatal blood cultures was significantly high with varying mortality, morbidity and methicillin-resistant CoNS observed. However, CoNS is still considered as a contaminant when the clinical course is not consistent with sepsis. The predominant species were Staphylococcus epidermidis, S. haemolyticus, S. hominis and S. capitis, which were being regarded as conditional pathogens or contaminants. Staphylococcus capitis NRCS-A clone was identified in 17 countries with marked multidrug resistance. High susceptibility of CoNS to linezolid and vancomycin were observed, except in S. capitis NRCS-A clone that showed treatment failure to aminoglycosides and vancomycin. Research on CoNS in neonatal sepsis will be a thriving area for years to come especially with its close association with hospital routine, assessing its pathogenic potential, the global spread of the multidrug-resistant NRCS-A clone of S. capitis and the introduction of vaccination opportunities. Adequate funding and collaboration of research effort will be required to address these key questions.