Emergence and establishment of Staphylococcus haemolyticus ST29 in two Western France neonatal intensive care units

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Dupin, C | Cissé, A | Lemoine, V | Turban, A | Marie, V | Mazille, N | Soive, S | Piau-Couapel, C | Youenou, B | Martins-Simoes, Patricia | Cattoir, Vincent | Tristan, Anne | Donnio, P. -Y. | Menard, G

Edité par CCSD ; WB Saunders -

International audience. Purpose: Since 2021, several reports of Staphylococcus haemolyticus outbreaks in neonatal intensive care units (NICUs) have been reported in France. The aim of this study was to understand how it became established in the NICUs of two facilities, which share the care of newborns.Methods: All positive S. haemolyticus clinical samples isolated from 2020 until 2023 and medical records were analysed. Phenotypic analyses consisted of typing method using the quantitative antibiogram (QA) method, and microbiological investigations using whole genome sequencing (WGS). Environmental samples and hands of healthcare workers were collected, with the same analyses realized if S. haemolyticus was identified. Observational studies of Healthcare workers (HCWs) hygiene practices were also performed.Results: One hundred and sixteen neonates were positive for S. haemolyticus, of whom 44 (38%) were infected. ST29 strains were highly predominant, and distinct clonal populations were identified. Transfers of newborns between the two centres, followed by cross-transmissions, could explain the dissemination of one population. Twenty-one environmental samples revealed the presence of the clones involved in neonates. One clonal population was also found on the hands of 15% of the healthcare workers sampled. Misconceptions about alcohol-based hand rub were observed, and daily disinfection of NICU equipment was not optimal.Conclusion: Preliminary reports point to cross-transmission within and between NICUs, either directly by healthcare worker hands or indirectly via contaminated environments, especially incubators. The ST29 lineage is identified in most NICUs with a capacity to adapt locally and to cause outbreaks.

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