Study of some virulence factors and antimicrobial resistance in coagulase-negative staphylococci isolated from newborns in mansoura hospitals

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International Journal of Development Research

Study of some virulence factors and antimicrobial resistance in coagulase-negative staphylococci isolated from newborns in mansoura hospitals

Abstract: 

A prospective study was performed at NICUs of three Mansoura hospitals in Egypt over a period of 18 months from March 2011 to August 2012. The three NICUs are participants in Egyptian Neonatal Network (EGNN).344 newborns were diagnosed as suspected sepsis. 58.57% of 140 positive blood cultures were due to Gram positive pathogens. Staphylococcus epidermidis was the most common species (33 isolate), followed by S. haemolyticus (20). Antimicrobial resistance could have a substantial impact on healthcare by adversely affecting mor¬bidity and mortality. 51.7% of all strains were multidrug-resistant. Oxacillin resistance was detected phenotypically in 85% (51/60) of the staphylococcal isolates, whilst genotypically, mec Agene was found in 88.3% (53/60) of the isolates. Characterization of SCCmec in MR-CoNS can generate useful information on the mobilization and evolution of this element which is epidemiologically important for infection control. Using multiplex PCR, only 37.7% of the mec A-positive strains could be assigned into known SCCmec. Among them, 12 had a single type, including type II (n = 4), V (n = 4), III (n = 3) and IV (n = 1), while 7 isolates had two types, II+IV (n= 2), II+V (n= 2), III+V (n= 2) and I+III (n= 1), and one isolate had three types including I+III+V. SCCmec types V, II and III (alone and combined) were the most prevalent among MR-CoNS isolated from neonatal sepsis cases. SCCmec types II and III were the most prevalent among S. epidermidis, while among S. haemolyticus isolates, was type V.Vancomycin is still the most effective antimicrobial agent against staphylococci isolates in NICUs, in addition to amikacin and imipenem and ciprofloxacin. Biofilm production and phenol soluble modulins (PSMs) are considered the main factors contributing to their virulence. Bio film production was positive in 44 isolates (73.3%) with a different adherence strengths. Psm β was found in 60% of all isolates, 86.1% (31/36) of them were S. epidermidis. Hemolysin production was mainly observed in S. haemolyticus isolates.

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