Bacterial Colonization of the Hospitalized Newborn: Competition Between Staphylococcus aureus and Staphylococcus epidermidis

Daniel C. Lee, Anchasa Kananurak, Michelle Tn Tran, Patricia A. Connolly, Christopher R Polage, Tadayuki Iwase, Charles L Bevins, Mark Underwood

Research output: Contribution to journalArticle

Abstract

BACKGROUND: In adults, Staphylococcus epidermidis and Staphylococcus aureus compete for colonization of the nasal mucosa and S. epidermidis strains that produce the Esp serine protease eradicate S. aureus nasal colonization. Whether similar phenomena are seen in newborn infants is unknown. METHODS: Nasal swabs were obtained on admission and discharge from newborn infants (n = 90 and 83, respectively) in the neonatal intensive care unit at UC Davis Children's Hospital. Swabs were cultured for S. aureus and S. epidermidis. S. epidermidis isolates were tested for Esp expression, overall secreted protease activity and biofilm inhibition. RESULTS: No infant had S. aureus on admission. S. epidermidis colonization was rare on admission in inborn infants (2.5%), but common in infants transferred from referring hospitals (50%). At discharge, most infants (96%) were colonized by staphylococci. S. aureus colonization was less common in infants with S. epidermidis colonization (9%) and more common in infants without S. epidermidis (77%) (relative risk of S. aureus colonization in infants colonized with S. epidermidis 0.18, 95% confidence interval: 0.089-0.34, P < 0.0001). Compared with S. epidermidis strains from infants without S. aureus, S. epidermidis from infants co-colonized with S. aureus had lower total proteolytic enzyme activity and decreased biofilm inhibition capacity, but did not have lower frequency of Esp positivity. CONCLUSIONS: In hospitalized neonates, S. epidermidis colonization has a protective effect against S. aureus colonization. Secretion of proteases by S. epidermidis is a possible mechanism of inhibition of S. aureus colonization; however, in this cohort of neonates, the source of major protease activity is likely other than Esp.

Original languageEnglish (US)
Pages (from-to)682-686
Number of pages5
JournalThe Pediatric infectious disease journal
Volume38
Issue number7
DOIs
StatePublished - Jul 1 2019

Fingerprint

Staphylococcus epidermidis
Staphylococcus aureus
Newborn Infant
Peptide Hydrolases
Biofilms
Nose
Nasal Mucosa
Neonatal Intensive Care Units
Serine Proteases
Staphylococcus
Confidence Intervals

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Bacterial Colonization of the Hospitalized Newborn : Competition Between Staphylococcus aureus and Staphylococcus epidermidis. / Lee, Daniel C.; Kananurak, Anchasa; Tran, Michelle Tn; Connolly, Patricia A.; Polage, Christopher R; Iwase, Tadayuki; Bevins, Charles L; Underwood, Mark.

In: The Pediatric infectious disease journal, Vol. 38, No. 7, 01.07.2019, p. 682-686.

Research output: Contribution to journalArticle

@article{441dce2304e54eaa8076200ff660a172,
title = "Bacterial Colonization of the Hospitalized Newborn: Competition Between Staphylococcus aureus and Staphylococcus epidermidis",
abstract = "BACKGROUND: In adults, Staphylococcus epidermidis and Staphylococcus aureus compete for colonization of the nasal mucosa and S. epidermidis strains that produce the Esp serine protease eradicate S. aureus nasal colonization. Whether similar phenomena are seen in newborn infants is unknown. METHODS: Nasal swabs were obtained on admission and discharge from newborn infants (n = 90 and 83, respectively) in the neonatal intensive care unit at UC Davis Children's Hospital. Swabs were cultured for S. aureus and S. epidermidis. S. epidermidis isolates were tested for Esp expression, overall secreted protease activity and biofilm inhibition. RESULTS: No infant had S. aureus on admission. S. epidermidis colonization was rare on admission in inborn infants (2.5{\%}), but common in infants transferred from referring hospitals (50{\%}). At discharge, most infants (96{\%}) were colonized by staphylococci. S. aureus colonization was less common in infants with S. epidermidis colonization (9{\%}) and more common in infants without S. epidermidis (77{\%}) (relative risk of S. aureus colonization in infants colonized with S. epidermidis 0.18, 95{\%} confidence interval: 0.089-0.34, P < 0.0001). Compared with S. epidermidis strains from infants without S. aureus, S. epidermidis from infants co-colonized with S. aureus had lower total proteolytic enzyme activity and decreased biofilm inhibition capacity, but did not have lower frequency of Esp positivity. CONCLUSIONS: In hospitalized neonates, S. epidermidis colonization has a protective effect against S. aureus colonization. Secretion of proteases by S. epidermidis is a possible mechanism of inhibition of S. aureus colonization; however, in this cohort of neonates, the source of major protease activity is likely other than Esp.",
author = "Lee, {Daniel C.} and Anchasa Kananurak and Tran, {Michelle Tn} and Connolly, {Patricia A.} and Polage, {Christopher R} and Tadayuki Iwase and Bevins, {Charles L} and Mark Underwood",
year = "2019",
month = "7",
day = "1",
doi = "10.1097/INF.0000000000002285",
language = "English (US)",
volume = "38",
pages = "682--686",
journal = "Pediatric Infectious Disease Journal",
issn = "0891-3668",
publisher = "Lippincott Williams and Wilkins",
number = "7",

}

TY - JOUR

T1 - Bacterial Colonization of the Hospitalized Newborn

T2 - Competition Between Staphylococcus aureus and Staphylococcus epidermidis

AU - Lee, Daniel C.

AU - Kananurak, Anchasa

AU - Tran, Michelle Tn

AU - Connolly, Patricia A.

AU - Polage, Christopher R

AU - Iwase, Tadayuki

AU - Bevins, Charles L

AU - Underwood, Mark

PY - 2019/7/1

Y1 - 2019/7/1

N2 - BACKGROUND: In adults, Staphylococcus epidermidis and Staphylococcus aureus compete for colonization of the nasal mucosa and S. epidermidis strains that produce the Esp serine protease eradicate S. aureus nasal colonization. Whether similar phenomena are seen in newborn infants is unknown. METHODS: Nasal swabs were obtained on admission and discharge from newborn infants (n = 90 and 83, respectively) in the neonatal intensive care unit at UC Davis Children's Hospital. Swabs were cultured for S. aureus and S. epidermidis. S. epidermidis isolates were tested for Esp expression, overall secreted protease activity and biofilm inhibition. RESULTS: No infant had S. aureus on admission. S. epidermidis colonization was rare on admission in inborn infants (2.5%), but common in infants transferred from referring hospitals (50%). At discharge, most infants (96%) were colonized by staphylococci. S. aureus colonization was less common in infants with S. epidermidis colonization (9%) and more common in infants without S. epidermidis (77%) (relative risk of S. aureus colonization in infants colonized with S. epidermidis 0.18, 95% confidence interval: 0.089-0.34, P < 0.0001). Compared with S. epidermidis strains from infants without S. aureus, S. epidermidis from infants co-colonized with S. aureus had lower total proteolytic enzyme activity and decreased biofilm inhibition capacity, but did not have lower frequency of Esp positivity. CONCLUSIONS: In hospitalized neonates, S. epidermidis colonization has a protective effect against S. aureus colonization. Secretion of proteases by S. epidermidis is a possible mechanism of inhibition of S. aureus colonization; however, in this cohort of neonates, the source of major protease activity is likely other than Esp.

AB - BACKGROUND: In adults, Staphylococcus epidermidis and Staphylococcus aureus compete for colonization of the nasal mucosa and S. epidermidis strains that produce the Esp serine protease eradicate S. aureus nasal colonization. Whether similar phenomena are seen in newborn infants is unknown. METHODS: Nasal swabs were obtained on admission and discharge from newborn infants (n = 90 and 83, respectively) in the neonatal intensive care unit at UC Davis Children's Hospital. Swabs were cultured for S. aureus and S. epidermidis. S. epidermidis isolates were tested for Esp expression, overall secreted protease activity and biofilm inhibition. RESULTS: No infant had S. aureus on admission. S. epidermidis colonization was rare on admission in inborn infants (2.5%), but common in infants transferred from referring hospitals (50%). At discharge, most infants (96%) were colonized by staphylococci. S. aureus colonization was less common in infants with S. epidermidis colonization (9%) and more common in infants without S. epidermidis (77%) (relative risk of S. aureus colonization in infants colonized with S. epidermidis 0.18, 95% confidence interval: 0.089-0.34, P < 0.0001). Compared with S. epidermidis strains from infants without S. aureus, S. epidermidis from infants co-colonized with S. aureus had lower total proteolytic enzyme activity and decreased biofilm inhibition capacity, but did not have lower frequency of Esp positivity. CONCLUSIONS: In hospitalized neonates, S. epidermidis colonization has a protective effect against S. aureus colonization. Secretion of proteases by S. epidermidis is a possible mechanism of inhibition of S. aureus colonization; however, in this cohort of neonates, the source of major protease activity is likely other than Esp.

UR - http://www.scopus.com/inward/record.url?scp=85068197647&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85068197647&partnerID=8YFLogxK

U2 - 10.1097/INF.0000000000002285

DO - 10.1097/INF.0000000000002285

M3 - Article

C2 - 30985510

AN - SCOPUS:85068197647

VL - 38

SP - 682

EP - 686

JO - Pediatric Infectious Disease Journal

JF - Pediatric Infectious Disease Journal

SN - 0891-3668

IS - 7

ER -