Coagulase negative Staphylococcus bacteremia in hematopoietic stem cell transplant recipients: Clinical features and molecular characterization

Acta Microbiol Immunol Hung. 2021 May 13;68(2):73-79. doi: 10.1556/030.2021.01315.

Abstract

The purpose of our study was to investigate the epidemiology of coagulase negative staphylococci (CoNS) responsible for bacteremia in hematopoietic stem cell transplant (HSCT) recipients and to determine the prevalence and the genetic background of methicillin resistance. The prevalence of CoNS bacteremia was 7.4% (54/728), higher in allograft (10.7%) than in autograft (4.7%) recipients. A sepsis or a septic shock were observed in 9% of cases. No deaths were attributable to CoNS bacteremia. The methicillin resistance rate was 81%. All MR-CoNS, harbored mecA gene and 90% were typeable with SCCmec typing using PCR amplification. The SCCmec type IV was the most frequent (44%). Clonal dissemination of MR- Staphylococcus epidermidis strains was limited. Our study showed a low prevalence and favorable outcome of CoNS bacteremia in HSCT recipients with limited clonal diffusion. However, they were associated with a significant rate of severe infections and a high rate of methicillin resistance, mediated by SCCmec IV element in most cases.

Keywords: SCCmec; bacteremia; coagulase negative staphylococci; hematopoietic stem cell transplant; mecA gene; pulsed-field gel electrophoresis.

MeSH terms

  • Adolescent
  • Adult
  • Anti-Bacterial Agents / pharmacology
  • Bacteremia / epidemiology*
  • Bacteremia / microbiology
  • Bacterial Proteins / genetics
  • Child
  • Coagulase / analysis
  • Coagulase / genetics*
  • DNA, Bacterial / genetics
  • Female
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Male
  • Methicillin Resistance / genetics
  • Microbial Sensitivity Tests
  • Middle Aged
  • Prevalence
  • Retrospective Studies
  • Staphylococcal Infections / complications
  • Staphylococcal Infections / epidemiology*
  • Staphylococcal Infections / etiology
  • Staphylococcus / drug effects
  • Staphylococcus / enzymology
  • Staphylococcus / genetics*
  • Staphylococcus / pathogenicity*
  • Staphylococcus epidermidis / drug effects
  • Staphylococcus epidermidis / genetics
  • Tunisia / epidemiology
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • Coagulase
  • DNA, Bacterial