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Prevalence and Clinical Relevance of Staphylococcus warneri in the Neonatal Intensive Care Unit

Published online by Cambridge University Press:  02 January 2015

Jeannie P. Cimiotti ,
Janet P. Haas ,
Phyllis Della-Latta ,
Fann Wu ,
Lisa Saiman  and
Elaine L. Larson
Jeannie P. Cimiotti*
Affiliation:
Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia
Janet P. Haas
Affiliation:
School of Nursing, New York, New York
Phyllis Della-Latta
Affiliation:
Department of Pathology, New York, New York
Fann Wu
Affiliation:
Department of Pathology, New York, New York
Lisa Saiman
Affiliation:
Department of Pediatrics, Columbia University, New York, New York Department of Epidemiology, Columbia University Medical Center, Columbia University, New York, New York New York-Presbyterian Hospital, New York, New York
Elaine L. Larson
Affiliation:
School of Nursing, New York, New York
*
University of Pennsylvania, Center for Health Outcomes and Policy Research, 420 Guardian Drive, 327R Nursing Education Building, Philadelphia, PA 19104-6096 (jcimiott@nursing.upenn.edu)
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Abstract

Objective.

To describe the prevalence of Staphylococcus warneri on the hands of nurses and the clinical relevance of this organism among neonates in the neonatal intensive care unit (NICU).

Design.

Prospective cohort study that examined the microbial flora on the hands of nurses and clinical isolates recovered from neonates during a 23-month period (March 1, 2001, through January 31, 2003).

Setting.

Two high-risk NICUs in New York City.

Participants.

All neonates hospitalized in the NICUs for more than 24 hours and all full-time nurses from the same NICUs who volunteered to participate.

Intervention.

At baseline and then every 3 months, samples for culture were obtained from each nurse's cleaned dominant hand. Pulsed-field electrophoresis compared S. warneri isolates from neonates and staff.

Results.

Samples for culture (n = 834) were obtained from the hands of 119 nurses; 520 (44%) of the 1,195 isolates of coagulase-negative staphylococci recovered were identified as S. warneri. Of the 647 clinically relevant isolates recovered from neonates, 17 (8%) of the 202 isolates that were identified to species level were S. warneri. Pulsed-field electrophoresis revealed a common strain of S. warneri that was shared among the nurses and neonates. Furthermore, 117 (23%) of 520 S. warneri isolates from nurses' hands had minimum inhibitory concentrations for vancomycin of 4 μg/mL, which indicate decreasing susceptibility.

Conclusions.

Our findings that S. warneri can be pathogenic in neonates, is a predominant species of coagulase-negative staphylococci cultured from the hands of nurses, and has decreased vancomycin susceptibility underscore the importance of continued surveillance for vancomycin resistance and pathogenicity in pediatric care settings.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 28 , Issue 3 , March 2007 , pp. 326 - 330
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007

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