Analysis of colonization rate and molecular characteristics of Staphylococcus aureus on tracheotomy wounds at early postoperational stage in neonates
10.3760/cma.j.cn112140-2024914-00645
- VernacularTitle:新生儿气管切开术后早期切口金黄色葡萄球菌定植率及分子型分析
- Author:
Jie YU
1
;
Enxia TIAN
;
Xiying XIANG
;
Xing ZHU
;
Juan DU
;
Kaihu YAO
;
Jie ZHANG
;
Mingyan HEI
Author Information
1. 首都医科大学附属北京儿童医院新生儿中心 教育部儿科重大疾病研究重点实验室，北京100045
- Publication Type:Journal Article
- Keywords:
Infant, newborn;
Staphylococcus aureus;
Colonization;
Infection;
Strain
- From:
Chinese Journal of Pediatrics
2025;63(4):399-404
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the colonization rate and molecular types of Staphylococcus aureus (SA) on the tracheotomy wounds of neonates at early postoperative stage in neonatal intensive care unit (NICU). Methods:This was a case series study. Patients who were admitted and underwent tracheotomy in NICU of Beijing Children′s Hospital, Capital Medical University from January 1 st 2020 to December 31 st 2023 were enrolled. Swabs on the skin around the incision or on the nasal mucosa were collected and cultured at 24, 72 and 168 h after operation. Coagulase test and Staphytect Plus kits were used for SA identification. The nuc gene amplification and molecular types of SA were assessed by PCR. The patients were divided into SA colonization group and non-colonization group based on the presence or absence of SA colonization, and into infection group and non-infection group based on the presence or absence of infection. Demographic data, hospitalization information, colonization and infection status of SA were collected from the digital medical record system of the hospital. Differences between groups were analyzed using the independent sample t test or Fisher exact test. Results:Totally 19 patients were enrolled, among whom 13 were male. The gestation age was 39.0 (38.1, 40.0) weeks, and the birth weight was 3 150 (2 600, 3 400) g. Tracheotomy was done at 8.2(4.1, 19.6) days after diagnosis and indication confirmed. Corrected gestational age of patients on the operation day was 43.6 (42.2, 45.4) weeks. The NICU stay time was (34.0±3.1) days. SA colonization was confirmed around the incision of 8 patients. Out of the 18 strains of colonized bacteria, 10 were methicillin-resistant Staphylococcus aureus (MRSA). The most common molecular type of MRSA was ST59-SCCmec Ⅳ-t437 strain (8 strains). A total of 10 patients presented typical clinical manifestations of bacterial infection at the lungs, 3 patients in the blood stream and 2 patients in the central nervous system. Among 10 patients with bacterial infection, 3 patients were MRSA positive by boby fluid culture and affected by the ST59-SCCmec Ⅳ-t437 strain. The infection rate was different between patients with or without SA colonization on the tracheotomy incision (7/8 vs. 3/11, P=0.020). Conclusions:The colonization rate and infection rate were high on the tracheotomy incision in neonates. The major type was MRSA, and the most common molecular strain was ST59-SCCmec Ⅳ-t437 .
