1887

Abstract

Coagulase-negative staphylococci (CNS), especially and , have emerged as opportunistic pathogens in immunocompromised patients and those with indwelling medical devices. In this study, CNS recovered from patients with bloodstream infections (BSIs) or prosthetic-device-associated infections (PDAIs) were compared in terms of biofilm formation, antimicrobial resistance, clonal distribution, and carriage of adhesin and toxin genes. A total of 226 CNS isolates (168 and 58 ) recovered from hospital inpatients with BSIs (100 isolates) or PDAIs (126 isolates) were tested for biofilm formation, antimicrobial susceptibility, and , operon, adhesin (, , , , ) and toxin (, , ) genes. The selected CNS were classified into pulsotypes by PFGE and assigned to sequence types by multilocus sequence typing. In total, 106/226 isolates (46.9 %) produced biofilm, whereas 150 (66.4 %) carried the operon. Most isolates carried and were multidrug resistant (90.7 %). CNS recovered from BSIs were significantly more likely to produce biofilm ( = 0.003), be resistant to antimicrobials and carry (<0.001), as compared with isolates derived from PDAIs. CNS from PDAIs were more likely to carry the and genes ( = 0.006 and  = 0.045, respectively). No significant differences in the carriage of toxin genes were identified (>0.05). Although PFGE revealed genetic diversity, especially among , analysis of representative strains from the main PFGE types by multilocus sequence typing revealed three major clones (ST2, ST5 and ST16). A clonal relationship was found with respect to antimicrobial susceptibility and and gene carriage, reinforcing the premise of clonal expansion in hospital settings. The results of this study suggest that the pathogenesis of BSIs is associated with biofilm formation and high-level antimicrobial resistance, whereas PDAIs are related to the adhesion capabilities of and strains.

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2014-11-01
2019-11-18
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