Monitoring Persistence of Coagulase-Negative Staphylococci in a Hematology Department Using Phenotypic and Genotypic Strategies

• Published in: Infection control and hospital epidemiology 1996-10, Vol.17 (10), p.660-667
• Main Authors: van Belkum, Alex, Kluijtmans, Jan, van Leeuwen, Willem, Goessens, Wil, ter Averst, Ellen, Wielenga, Jenne, Verbrugh, Henri
• Format: Article
• Language: English
• Subjects: Antibiotics; Bacteremia - epidemiology; Bacterial Typing Techniques - standards; Bacteriology; Biological and medical sciences; Blood; Catheters; Coagulase - analysis; Cross Infection - epidemiology; DNA; Electrophoresis; Electrophoresis, Gel, Pulsed-Field - standards; Epidemiology; Fundamental and applied biological sciences. Psychology; Gels; Hematology; Humans; Infections; Inpatients - statistics & numerical data; Microbial Sensitivity Tests; Microbiology; Neoplasms; Netherlands - epidemiology; Nursing; Polymerase chain reaction; Polymerase Chain Reaction - standards; Population Surveillance - methods; Prospective Studies; Staphylococcal Infections - epidemiology; Staphylococcus; Staphylococcus aureus - classification; Staphylococcus aureus - enzymology; Staphylococcus aureus - genetics; Staphylococcus aureus - isolation & purification
• ISSN: 0899-823X; 1559-6834
• DOI: 10.1017/S0195941700002964

Objective: To determine persistence of coagulasenegative staphylococci (CNS) on a hematology-oncology ward and to determine the value of phenotypic and genotypic procedures for establishing clonality among CNS isolates. Design: Strains of CNS isolated from bacteremic patients (n=139) were typed by biochemical reactivity, antibiotic susceptibility, DNA macrorestriction analysis by pulsedfield gel electrophoresis (PFGE), and arbitrary primed polymerase chain reaction (AP PCR). Coagulase-negative staphylococci were subgrouped in a random collection (n=20) used for the evaluation of the typing procedures and a collection of 119 CNS isolates from hematologic patients displaying multiple bacteremic episodes. Results: Analysis of the reference collection demonstrated the usefulness of the DNA typing procedures, indicating that AP PCR and PFGE can be used for epidemiologic typing of CNS in a concordant fashion. Certain strains appeared to be permanent colonizers of the hematology ward or ward-related personnel. In individual patients, persistent colonization by a single type was demonstrated. However, a number of patients also experienced bacteremic episodes caused by CNS belonging to different types. Conclusion: We conclude that monitoring of CNS infections on a hematology ward by various genotypic techniques provides insight into nosocomial epidemiology and elucidates the complexity of the infections taking place. DNA typing is preferred over phenotypic procedures and can identify persistent CNS strains in a given location.