冰岛新生儿感染头状葡萄球菌NRCS-A:一项对新生儿重症监护病房患者、工作人员和环境菌株的12年纵向回顾性研究。

IF 4.4 2区 医学 Q1 INFECTIOUS DISEASES
Ingibjörg Hilmarsdóttir, Kristján Orri Helgason, Álfheidur Thórsdóttir, Mélanie Bonhomme, Jóhanna Dröfn Stefánsdóttir, Ásdís Elfarsdóttir Jelle, Thórdur Thórkelsson, Frédéric Laurent, Marine Butin
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引用次数: 0

摘要

背景:耐多药头葡萄球菌(SC)的NRCS-A克隆已经在新生儿重症监护病房(NICUs)全球传播,在那里它导致新生儿败血症和婴儿、真菌和工作人员的定植。国际分离株的全基因组测序(WGS)表明,克隆的假定起源在挪威,这在地缘政治上与冰岛密切相关。目前还没有关于冰岛NRCS-A克隆体的数据,2014年冰岛的一例新生儿败血症首次表明它的存在。本研究调查了冰岛单一新生儿重症监护病房12年期间克隆的流行病学及其与国际分离株的关系。方法:回顾性分析2009 - 2020年婴幼儿血培养中分离的SC- nrcs - a的发生情况及临床意义,并对婴幼儿、工作人员和环境中SC进行前瞻性筛查。对选定的分离株进行WGS,以验证SC-NRCS-A克隆的存在,检查冰岛分离株之间的系统发育关系,并将其与国际上收集的SC-NRCS-A进行比较。结果:在28例婴儿的血培养中发现SC-NRCS-A,其中9例为败血症,是婴儿和多种细菌的常见定植菌。在工作人员的鼻腔、咽喉和头皮中检测到SC-NRCS-A。对93株血液分离株和前瞻性筛选标本进行WGS分析,并与国际分离株进行比较,结果表明冰岛SC-NRCS-A分布为两个聚类,一个与挪威SC-NRCS-A分离株相关,另一个与爱尔兰SC-NRCS-A分离株相关。两个聚类都包含代表所有样本源的分离株。结论:本研究证实了SC-NRCS-A克隆在冰岛NICU的患者间传播、广泛传播和持久性。冰岛分离株与挪威和爱尔兰分离株的密切系统发育关系表明,在2009年之前爱尔兰克隆株和2014年之前挪威克隆株可能由新生儿重症监护室工作人员或在这些邻国接受医疗护理的婴儿进口到冰岛。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Neonatal infection with Staphylococcus capitis NRCS-A in Iceland: A 12-year longitudinal, retrospective study of strains from patients, staff and the environment in a neonatal intensive care unit.

Background: The multidrug resistant NRCS-A clone of Staphylococcus capitis (SC) has spread globally in neonatal intensive care units (NICUs) where it causes neonatal sepsis and colonisation of infants, fomites and staff. Whole genome sequencing (WGS) of international isolates has suggested a putative origin of the clone in Norway, which is closely related to Iceland geopolitically. No data have been available about the NRCS-A clone in Iceland where a case of neonatal sepsis in 2014 suggested its presence for the first time. This study examines the epidemiology of the clone in the single Icelandic NICU over a 12-year period and its relationship to international isolates.

Methods: The study involved retrospective examination of the occurrence and clinical significance of SC-NRCS-A isolated from blood cultures of infants during 2009 - 2020, and prospective screening for SC among infants, staff and the environment. WGS was done on selected isolates to verify the presence of the SC-NRCS-A clone, examine phylogenetic relationship within the Icelandic isolates, and compare them with an international collection of SC-NRCS-A.

Results: SC-NRCS-A was found in blood cultures from 28 infants, of which nine with sepsis, and was a frequent coloniser of infants and diverse fomites. In staff SC-NRCS-A was detected in nares, throat and scalp. WGS of 93 isolates from blood and prospective screening specimens and comparison with international isolates revealed that the Icelandic SC-NRCS-A was distributed into two clusters, one related to Norwegian and the other to Irish SC-NRCS-A isolates. Both clusters contained isolates representing all sample sources.

Conclusion: The study demonstrated interpatient transmission, widespread dissemination and persistence of the SC-NRCS-A clone in the Icelandic NICU. The close phylogenetic relationship of Icelandic isolates with those from Norway and Ireland suggests potential import to Iceland by NICU staff or infants receiving medical care in these neighbouring countries at some point before 2009 for the Irish clone and before 2014 for the Norwegian clone.

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来源期刊
Antimicrobial Resistance and Infection Control
Antimicrobial Resistance and Infection Control PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES
CiteScore
9.70
自引率
3.60%
发文量
140
审稿时长
13 weeks
期刊介绍: Antimicrobial Resistance and Infection Control is a global forum for all those working on the prevention, diagnostic and treatment of health-care associated infections and antimicrobial resistance development in all health-care settings. The journal covers a broad spectrum of preeminent practices and best available data to the top interventional and translational research, and innovative developments in the field of infection control.
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