Molecular epidemiology of coagulase-negative staphylococcal bacteraemia in a newborn intensive care unit.

We isolated 55 coagulase-negative staphylococci (CoNS) over two separate 12-month periods (26 in 1993 and 29 in 1996) from the blood of neonates in a neonatal intensive case unit (NICU) in Melbourne, Australia and compared them by pulse-field gel electrophoresis profile (PFGE), random amplification of polymorphic DNA (RAPD) and antibiogram. The most common species were Staphylococcus epidermidis, S. haemolyticus and S. warneri. The majority of such isolates were resistant to penicillin and to either or both of methicillin and gentamicin. During 1993, there was an increase in the number of CoNS bloodstream infections compared with previous years. S. epidermidis was the most common isolate, with 88% assessed as clinically relevant. Using the three typing systems, we identified one likely epidemic clone of S. epidermidis, the isolates of which were resistant to penicillin, gentamicin and erythromycin and possessed the mecA gene. There was complete correlation between the detection of mecA and the phenotypic expression of resistance when zone diameters in the disc diffusion assay were interpreted according to the latest NCCLS guidelines (1999). Profiles of the remaining 1993 isolates were generally heterogeneous, suggesting independent acquisition with some evidence of cross-infection. The predominant bloodstream isolates in 1996 were heterogeneous multi-resistant strains of S. epidermidis, S. haemolyticus and S. warneri, about half of which were assessed as clinically relevant. These data support the view that CoNS are significant nosocomial pathogens in NICU and that resistant clones may be transmitted between babies. Molecular epidemiological tools are helpful for understanding transmission patterns and sources of infection, and are useful for measuring outcomes of intervention strategies implemented to reduce nosocomial CoNS sepsis. PFGE was found to be more discriminatory than RAPD, but the latter provides results in a more timely manner.

Molecular typing of Staphylococcus aureus of bovine origin by polymorphisms of the coagulase gene.

Mastitis caused by Staphylococcus aureus is a disease of major economic importance to the dairy industry. Transmission occurs during milking, with chronically-infected cows acting as the major reservoirs of infection. PCR-coagulase gene typing of 151 S. aureus isolates from seven farms generated only six PCR types, with 110 (73%) isolates assigned to PCR type 1 and 23 (15.2%) isolates assigned to type 2. PCR type 1 was the predominant type on five of the seven farms, including farms in geographically separated regions of Victoria, while type 2 predominated on two farms. With the exception of the 41 isolates from one farm, all isolates were resistant to penicillin, but susceptible to other antibiotics that are routinely used to manage mastitis in dairy cattle. Nine of 11 cows with chronic S. aureus infection showed evidence of persistence of a single PCR type for periods of up to 9 months. Two different PCR types of S. aureus were isolated from the other two cows over the same period.