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Journal of Clinical Microbiology, October 2003, p. 4660-4665, Vol. 41, No. 10
0095-1137/03/$08.00+0     DOI: 10.1128/JCM.41.10.4660-4665.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

Decreased Vancomycin Susceptibility of Coagulase-Negative Staphylococci in a Neonatal Intensive Care Unit: Evidence of Spread of Staphylococcus warneri

Kimberly J. Center,1* Annette C. Reboli,2 Robin Hubler,1 Gail L. Rodgers,1 and Sarah S. Long1

St. Christopher's Hospital for Children, Drexel University College of Medicine, Philadelphia, Pennsylvania,1 University of Medicine and Dentistry of New Jersey/Robert Wood Johnson Medical School at Camden, Camden, New Jersey2

Received 11 February 2003/ Returned for modification 19 March 2003/ Accepted 16 June 2003

Coagulase-negative staphylococci (CoNS) are important pathogens in premature neonates; decreasing glycopeptide susceptibility has been observed among these isolates. The epidemiology of colonization with CoNS, the organisms' vancomycin susceptibilities, and genetic relatedness were studied over 6 months in a tertiary-care neonatal unit. A total of 321 isolates of CoNS were isolated. Seventy-five percent of the infants were colonized at admission, and virtually all were colonized thereafter. Common species were Staphylococcus epidermidis (69%), S. warneri (12%), S. haemolyticus (9.7%), and S. hominis (5.6%). A total of 3.9% of CoNS isolates had decreased vancomycin susceptibility (DVS) (MICs > 2.0 µg/ml); isolate recovery was associated with a stay in a neonatal intensive care unit for >28 days (P = 0.039), vancomycin exposure (P = 0.021), and S. warneri colonization (P < 0.0001). Nine of 12 (75%) CoNS with DVS were S. warneri, had enhanceable high-level resistance in vitro, were indistinguishable or closely related by pulsed-field gel electrophoresis, and were different from 29 vancomycin-susceptible S. warneri isolates. Epidemiological analysis suggested unsuspected nosocomial spread. Species determination in certain settings may aid in the understanding of emerging nosocomial problems.

* Corresponding author. Mailing address: Section of Infectious Diseases, St. Christopher's Hospital for Children, Erie Ave. at Front St., Philadelphia, PA 19134. Phone: (215) 427-5201. Fax: (215) 427-8389. E-mail: kjcn0124{at}aol.com.

Journal of Clinical Microbiology, October 2003, p. 4660-4665, Vol. 41, No. 10
0095-1137/03/$08.00+0     DOI: 10.1128/JCM.41.10.4660-4665.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.



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