Determination Coagulase-nagative Staphylococcus and Antibiotic Susceptibility Patterns in Cases of Sepsis in the Neonatal Intensive Care Unit of Amiens-Picardie University Hospital (France)

Abstract

Neonatal sepsis is the most serious disease encountered in the neonatal Intensive Care Unit, and is associated with high morbidity and mortality rates. Here, we evaluated coagulase-negative Staphylococcus strains and the corresponding antibiotic susceptibility profiles in clinically suspected cases of neonatal sepsis. The objectives of the study were to determine the significance of coagulase-negative Staphylococcus strains isolated from cases of neonatal sepsis, another isolation site for coagulase-negative Staphylococcus other than blood culture and their susceptibility pattern. In a prospective study of newborns admitted to our neonatal Intensive Care Unit between January 20^th, 2017, and January 20^th, 2019, we analyzed all cases of sepsis with a positive blood culture, and available stool, central venous catheter, tracheobronchial, and nasopharyngeal fluid. Strains were identified using Matrix-Assisted-Laser Desorption Ionization Time of Flight Mass Spectrometry. Antimicrobial susceptibility patterns were recorded and analyzed. Of 157 premature newborns enrolled in the study, 28 (17.8%) had a coagulase-negative Staphyloccus-positive blood culture. Eighteen (64.2%) presented with early onset sepsis and 10 (35.8%) presented with late onset sepsis. Based on the gestational age at birth, there were 10 (35%) extremely preterm newborns, 12 (42.8%) very preterm newborns, and 6 (21.5%) moderately preterm newborns. The birth weight was extremely low in 13 (46.4%), very low in 9 (32.2%), low in 4 (14.2%), and normal 2 (7.2%). All coagulase-negative Staphylococcus isolates showed high levels of resistance to cefoxitin (100% of the strains), aminoglycosides (100%), fusidic acid and, ofloxacin (100%). The isolates were highly susceptible to pristinamycin (100% of the strains), vancomycin (100%) and trimethoprim-sulfamethoxazole (100%). Coagulase-negative Staphylococcus isolates constituted the most frequent cause of neonatal sepsis. The abundance of these strains may contribute to the emergence of multi-drug resistance.