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Journal of Clinical Microbiology, October 2008, p. 3391-3396, Vol. 46, No. 10
0095-1137/08/$08.00+0     doi:10.1128/JCM.00115-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.

Clonal Dissemination of Staphylococcus epidermidis in an Oncology Ward{triangledown}

Kenneth L. Muldrew,1,{dagger} Yi-Wei Tang,1,2 Haijing Li,2 and Charles W. Stratton1,2*

Departments of Pathology,1 Medicine, Vanderbilt University, School of Medicine, Nashville, Tennessee2

Received 20 January 2008/ Returned for modification 23 March 2008/ Accepted 27 July 2008

Coagulase-negative staphylococci (CoNS) are the main cause of catheter-related infections, especially among immunosuppressed and neutropenic patients, as well as a source of bacterial contamination in blood cultures. Using biochemical identification and pulsed-field gel electrophoresis (PFGE), we sought to identify possible clonal isolates of bacteremia in patients with central lines in an oncology ward (OW), with comparison to isolates that were recovered by venipuncture from an adult emergency room (ER). A total of 243 CoNS isolates were identified to species level from the OW (126) and ER (117), with Staphylococcus epidermidis isolates being the most common (OW, 79.4%; ER, 45.3%). PFGE demonstrated a predominant clone of S. epidermidis (major subtype A) which was 35.5 times more likely (odds ratio [OR] = 35.5; 95% confidence interval [CI] = 4.7 to 267.0; P < 0.00001) to be present in the OW versus the ER. These (CoNS or major subtype A) isolates were more frequently resistant to gentamicin (OR = 2.83; 95% CI = 1.23 to 6.53; P = 0.016) and less frequently resistant to trimethoprim-sulfamethoxazole (OR = 0.38; 95% CI = 0.18 to 0.80; P = 0.013). Subset analysis of S. epidermidis isolates 2 years after the study period showed the persistence of the clone of major subtype A within the OW. This study demonstrates the presence of a predominant clone among central line isolates from an OW that is not present in CoNS venipuncture isolates from an ER.

* Corresponding author. Mailing address: Clinical Microbiology Laboratory, Vanderbilt University Medical Center, Room 4525-TVC, 21st & Edgehill Road, Nashville, TN 37232-5310. Phone: (615) 343-9063. Fax: (615) 343-8420. E-mail: charles.stratton{at}vanderbilt.edu

{triangledown} Published ahead of print on 6 August 2008.

{dagger} Current address: Department of Internal Medicine, Section of Infectious Diseases, Yale University School of Medicine, New Haven, CT.

Journal of Clinical Microbiology, October 2008, p. 3391-3396, Vol. 46, No. 10
0095-1137/08/$08.00+0     doi:10.1128/JCM.00115-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.





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