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Alteration of the colonization pattern of coagulase-negative staphylococci in patients undergoing treatment for hematological malignancy
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Division of Hematology, Department of Medicine,Örebro University Hospital, Örebro, Sweden.
Department of Infectious Diseases, Örebro University Hospital, Örebro, Sweden.
Örebro University, School of Medicine, Örebro University, Sweden. Department of Infectious Diseases, Örebro University Hospital, Örebro, Sweden.
Örebro University, School of Medicine, Örebro University, Sweden. Clinical Microbiology, Department of Laboratory Medicine, Örebro University Hospital, Örebro, Sweden.ORCID iD: 0000-0001-5939-2932
2012 (English)In: European Journal of Clinical Microbiology and Infectious Diseases, ISSN 0934-9723, E-ISSN 1435-4373, Vol. 31, no 7, p. 1679-1687Article in journal (Refereed) Published
Abstract [en]

The aim was to prospectively describe the colonization pattern of coagulase-negative staphylococci (CoNS) and the relationship between colonizing and invasive CoNS isolates among patients undergoing treatment for hematological malignancy. Fourteen newly diagnosed patients were included with either multiple myeloma or acute leukemia. Patients were repeatedly sampled from nares, throat, axillae, and perineum, and the CoNS isolates obtained were phenotypically characterized together with blood isolates of CoNS using the PhenePlate system (PhP). During the treatment a gradual reduction in the heterogeneity of colonizing CoNS was observed as well as an inter-patient accumulation of phenotypically related and multi-drug-resistant CoNS. These clusters of CoNS persisted for 2–3 months after the end of therapy. Ten positive blood cultures of CoNS were obtained and in the majority of these cases CoNS of the same PhP type were found in superficial cultures collected prior to the blood culture sampling. In conclusion, the study shows that therapy for hematological malignancy is associated with a homogenization of colonizing CoNS isolates and that this acquired flora of CoNS is persistent several months after the end of therapy. Furthermore, the results suggest that the source of bloodstream infections of CoNS in hematological patients is colonizing CoNS of the skin and mucosa.

Place, publisher, year, edition, pages
New York, USA: Springer, 2012. Vol. 31, no 7, p. 1679-1687
National Category
Clinical Medicine Infectious Medicine
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-22579DOI: 10.1007/s10096-011-1493-6ISI: 000304652800051PubMedID: 22124538Scopus ID: 2-s2.0-84865591558OAI: oai:DiVA.org:oru-22579DiVA, id: diva2:516602
Note

Funding Agency:

research committee of Örebro County Council, Sweden

Available from: 2012-04-18 Created: 2012-04-18 Last updated: 2018-04-16Bibliographically approved
In thesis
1. Coagulase-negative staphylococci in hematological malignancy
Open this publication in new window or tab >>Coagulase-negative staphylococci in hematological malignancy
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Bacterial infections are common in hematological malignancy. Coagulase-negative staphylococci (CoNS) are among the most prevalent causes of bacteremia in patients with hematological malignancies.

In this thesis, different aspects of CoNS in hematological malignancy have been studied in four papers:

In paper 1, CoNS blood culture isolates from patients with hematological malignancies treated at the University Hospital of Örebro from 1980 to 2009 were revaluated for the presence of reduced sensitivity to glycopeptides. A high incidence of heterogeneous-intermediate glycopeptide resistance was observed and there was a trend towards increasing incidence of this phenotype over time.

In paper 2, the colonization pattern of CoNS among patients undergoing intensive chemotherapy for hematological malignancy was investigated. A successive homogenization and an accumulation of CoNS phenotypes mutually present in a majority of included patients were demonstrated.

In paper 3, a PCR method to determine the clinical significance of positive blood cultures of the CoNS species Staphylococcus epidermidis was evaluated. The test failed to discriminate bloodstream infection from blood culture contamination.

Finally, in paper 4, the long-term molecular epidemiology of S. epidermidis blood culture isolates from patients with hematological malignancies was studied with multilocus sequence typing. A predominance of sequence type 2 was demonstrated during the entire 30 year study period.

In conclusion, the results are consistent with that CoNS have established as important pathogens by its capacity to colonize the human skin, its ability to reside and spread in the hospital environment and its rapid adaptation to stressors such as antimicrobials.

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2013. p. 56
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 95
Keywords
coagulase-negative staphylococci, hematological malignancy, Staphylococcus epidermidis, healthcare-associated infection, antibiotic susceptibility, molecular epidemiology, bloddstream infection, bacteremia
National Category
Hematology
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-30750 (URN)978-91-7668-970-7 (ISBN)
Public defence
2013-10-15, Wilandersalen, Universitetssjukhuset i Örebro, S. Grev Roseng. 18, 703 62 ÖREBRO, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2013-09-09 Created: 2013-09-09 Last updated: 2017-10-17Bibliographically approved

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Ahlstrand, ErikTidefelt, UlfSöderquist, Bo

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