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Emergence of multidrug-resistant Staphylococcus haemolyticus in neonatal intensive care unit in Southern France, a genomic study
Open accessAbstract
An emergence of multidrug-resistant (MDR) Staphylococcus haemolyticus has been observed in the neonatal intensive care unit (NICU) of Nîmes University Hospital in southern France. A case-control analysis was conducted on 96 neonates, to identify risk factors associated with S. haemolyticus infection, focusing on clinical outcomes. Forty-eight MDR S. haemolyticus strains, isolated from neonates between October 2019 and July 2022, were investigated using routine in vitro procedures and whole-genome sequencing. Additionally, five S. haemolyticus isolates from adult patients were sequenced to identify clusters circulating within the hospital environment. The incidence of neonatal S. haemolyticus was significantly associated with low birth weight, lower gestational age, and central catheter use (p<0.001). Sepsis was the most frequent clinical manifestation in this series (20/46, 43.5%) and was associated with five deaths. Based on whole-genome analysis, three S. haemolyticus genotypes were predicted: ST1 (6/53, 11%), ST25 (3/53, 5.7%), and ST29 (44/53, 83%), which included the subcluster II-A, predominantly emerging in the neonatal department. All strains were profiled in silico to be resistant to methicillin, erythromycin, aminoglycosides, and fluoroquinolones, consistent with in vitro antibiotic susceptibility tests. Moreover, in silico prediction of biofilm formation and virulence-encoding genes supported the association of ST29 with severe clinical outcomes, while the persistence in the NICU could be explained by the presence of antiseptic and heavy metal resistance-encoding genes. The clonality of S. haemolyticus ST29 subcluster II-A isolates confirms healthcare transmission causing severe infections. Based on these results, reinforced hygiene measures are necessary to eradicate the nosocomial transmission of MDR strains.
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Key S. haemolyticus sequence types included methicillin-resistant ST1, linked to NICUs previously, and ST49, associated with children and often resistant to methicillin.
“Of particular note, key S. haemolyticus STs included methicillin-resistant ST1, linked to NICUs previously34 and ST49, associated with children and often resistant to methicillin35,36.”
From Impact of early life antibiotic and probiotic treatment on gut microbiome and resistome of very-low-birth-weight preterm infants. (2025) · cites this paper as [34]
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Kiu, R., Darby, E. M., Alcon-Giner, C., Acuna-Gonzalez, A., Camargo, A., Lamberte, L. E., Phillips, S., Sim, K., Shaw, A. G., Clarke, P., et al. (2025) · Nature communications · doi:10.1038/s41467-025-62584-2 · Cited by 36
“Of particular note, key S. haemolyticus STs included methicillin-resistant ST1, linked to NICUs previously 34 and ST49, associated with children and often resistant to methicillin 35,36 .”
Metadata
- Authors
- Magnan, C., Morsli, M., Salipante, F., Thiry, B., Attar, J. E., Maio, M. D., Safaria, M., Tran, T.-A., Dunyach-Remy, C., Ory, J., Richaud-Morel, B., Sotto, A., Pantel, A., & Lavigne, J.-P.
- Affiliations
- Inserm (FR)
- Université de Montpellier (FR)
- Centre Hospitalier Universitaire de Nîmes (FR)
- Department of Paediatrics, CHU Nîmes, Nîmes, France
- VBIC, Univ Montpellier, INSERM U1047, Department of Microbiology and Hospital Hygiene, CHU Nîmes, Univ. Montpellier, Nîmes, France
- Corresponding author
- Lavigne, Jean-Philippe
- ORCID
- Venue
- Emerging Microbes & Infections
- Publisher
- Informa UK Limited
- Published
- 2024-05-26
- Volume
- 13
- Issue
- 1
- Pages
- 2353291-2353291
- ISSN
- 2222-1751 (ISSN-L)
- PMC
- PMC11132433
- OpenAlex
- W4396863979
- Cited by
- 24
- References
- 51
- Citations by year
- 2026: 12 · 2025: 11 · 2024: 1
- FWCI
- 8.25
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Emerging Microbes & Infections (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- HAL (submittedVersion, cc-by-nc)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antimicrobial Resistance in Staphylococcus
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal and Maternal Infections
- Health Sciences › Medicine › Microbiology (medical) › Infections and bacterial resistance
- Keywords
- Staphylococcus haemolyticus, multidrug resistance, neonatal sepsis, neonatal intensive care unit, nosocomial transmission, ST1, ST25, biofilm formation, virulence genes, antiseptic resistance, heavy metal resistance, central venous catheters, low birth weight, nosocomial infections
- MeSH terms
- Whole Genome Sequencing, Anti-Bacterial Agents, Cross Infection, Female, France, Genotype, Humans, Infant, Newborn, Intensive Care Units, Neonatal, Male, Microbial Sensitivity Tests, Risk Factors, Staphylococcal Infections, Case-Control Studies, Genome, Bacterial, Drug Resistance, Multiple, Bacterial, Staphylococcus haemolyticus
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