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

Published online by Cambridge University Press:  02 January 2015

Alex van Belkum ,
Jan Kluijtmans ,
Willem van Leeuwen ,
Wil Goessens ,
Ellen ter Averst ,
Jenne Wielenga  and
Henri Verbrugh
Alex van Belkum*
Affiliation:
Department of Bacteriology, University Hospital Dijkzigt, Rotterdam, The Netherlands
Jan Kluijtmans
Affiliation:
Department of Bacteriology, University Hospital Dijkzigt, Rotterdam, The Netherlands
Willem van Leeuwen
Affiliation:
Department of Bacteriology, University Hospital Dijkzigt, Rotterdam, The Netherlands
Wil Goessens
Affiliation:
Department of Bacteriology, University Hospital Dijkzigt, Rotterdam, The Netherlands
Ellen ter Averst
Affiliation:
Department of Bacteriology, University Hospital Dijkzigt, Rotterdam, The Netherlands
Jenne Wielenga
Affiliation:
Department of Hematology, University Hospital Dijkzigt, Rotterdam, The Netherlands
Henri Verbrugh
Affiliation:
Department of Bacteriology, University Hospital Dijkzigt, Rotterdam, The Netherlands
*
University Hospital Dijkzigt, Department of Bacteriology, Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
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Abstract

Objective:

To determine persistence of coagulase-negative 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 pulsed-field 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.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 17 , Issue 10 , October 1996 , pp. 660 - 667
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1996

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