%0 Journal Article %A Peixoto, Patricia Borges %A Massinhani, Fernando Henrique %A Netto dos Santos, Kátia Regina %A Chamon, Raiane Cardoso %A Silva, Renata Beatriz %A Lopes Correa, Fábio Ederson %A Barata Oliveira, Cristina da Cunha Hueb %A Oliveira, Adriana Gonçalves %T Methicillin-resistant Staphylococcus epidermidis isolates with reduced vancomycin susceptibility from bloodstream infections in a neonatal intensive care unit %D 2020 %J Journal of Medical Microbiology, %V 69 %N 1 %P 41-45 %@ 1473-5644 %R https://doi.org/10.1099/jmm.0.001117 %K coagulase-negative staphylococci %K SCCmec %K vancomycin heteroresistance %K sepsis %K neonate %I Microbiology Society, %X Introduction. Vancomycin has become the first-line therapy for most infections caused by methicillin-resistant staphylococci. Aim. To evaluate the vancomycin MIC, staphylococcal cassette chromosome mec (SCCmec) types and clonality of coagulase-negative staphylococci (CoNS) isolates recovered from neonates with true primary bloodstream infections (BSI). Methodology. CoNS isolates were prospectively recovered from blood cultures of non-repetitive patients admitted to a neonatal intensive care unit (NICU) in a tertiary-care hospital during a 3-year period. BSI was defined based on established criteria. Micro-organisms were identified phenotypically and by PCR. MIC-values for vancomycin and oxacillin were determined by broth dilution method and E-test. The SCCmec type conferring methicillin resistance was determined by multiplex PCR. The heterogeneous vancomycin (hV) resistance phenotype was screened on brain heart infusion agar containing 4 µg ml−1 of vancomycin. The clonality was investigated by PFGE. Results. Seventy-four CoNS isolates were recovered from blood cultures of neonates during the study period but only 40 (54 %) were associated with true primary BSI. Nine (22.5%) babies died. Staphylococcus epidermidis was the most prevalent species (95 %; 38/40). All S. epidermidis isolates were methicillin-resistant (MR). SCCmec type IV was predominant (55.3 %; 21/38). Most (80.0 %; 32/38) isolates exhibited vancomycin MIC-values of 2–4 µg ml−1 not associated with the SCCmec type or clonality. Sixteen (42.1%) isolates displayed hV resistance. All babies who died were harbouring MR- S. epidermidis exhibiting vancomycin MICs of 2–4 µg ml−1. Conclusion. The findings of this study demonstrated that blood invasive MR- S. epidermidis isolates recovered at NICU tend to show decreased vancomycin susceptibility making therapy of those fragile patients difficult. %U https://www.microbiologyresearch.org/content/journal/jmm/10.1099/jmm.0.001117