Transcription profiles of skin and head kidney from goldfish suffering hemorrhagic septicemia with an emphasis on the TLR signaling pathway

DEAR EDITOR, Hemorrhagic septicemia is an acute, highly fatal disease that affects goldfish (Carassius auratus). To gain a better understanding of related immune genes, the transcriptomes of the skin and head kidney of goldfish suffering hemorrhagic septicemia were sequeneed, assembled, and characterized.

Pseudomonas aeruginosa Community Acquired Pneumonia with Septicemia in a Previously Healthy Woman

A previously healthy 53-year-old woman was urgently hospitalized due to septic shock. She was diagnosed with bacterial pneumonia based on chest radiograph and computed tomography findings of right upper lobe consolidation. Sputum Gramstain at the time of admission showed gram-negative rods with phagocytosis. Intravenous meropenem was immediately initiated as empiric antibacterial therapy. Bacterial culture specimens from sputum and blood were positive for Pseudomonas aeruginosa. Following appropriate antibiotic therapies, the patient recovered from a shock state and gradually became well. There has been no evidence of recurrence at 6 months after discharge. P. aeruginosa community acquired pneumonia with septicemia is rapidly progressive and often fatal. The choice of initial empiric antibiotic treatment that is active against P. aeruginosa is critical in improving outcome.

Establishment of Pyrosequencing Technology for Detecting Viral Hemorrhagic Septicemia Virus (VHSV)

[Objective] The paper was to establish pyrosequencing methods for detecting viral hemorrhagic septicemia virus （VHSV）. [ Method ] One pair of PCR primers and one pyrosequencing primer of VHSV were designed. The pyrosequencing reaction system and conditions were optimized and the pyrosequencing method for detecting VHSV was established. [ Result] This method was only able to specifically detect the objective viruses in the eight fish viruses, and the method had the advantage of high sensitivity. The minimum detectable limit of nucleic acid was 82 copies/μL. The method was verified by detecting VHSV in 1 924 batches of samples collected from domestic and imported fishes. The detection results were consistent with that of traditional RT-PCR, and the specificity and sensitivity of the method could meet the detection requirement for aquatic animal diseases. [ Conclusion] The study provides a new detection method for monitoring and prevention and control of aquatic animal virus diseases.

<i>Vibrio vulnificus</i>septicemia and necrotizing fasciitis in the patients with liver cirrhosis and diabetes mellitus

Vibrio vulnificus (V. vulnificus) infection is a rare disease in Japan but the leading cause of death related to raw seafood consumption. We hereby reported a successfully treated case of V. vulnificus septicemia, severe necrotizing fasciitis, disseminated intravascular coagulation and multiple organ failure after raw perch consumption with underlying alcoholic liver cirrhosis and diabetes mellitus. It is the first report of a case of V. vulnificusinfection caused by eating raw perch, whereas V. vulnificus infection should be suspected in all of middle-aged to elderly men with underlying immunosuppressive diseases, who have recent consumption of raw seafood or contact with seawater, especially in the summer. The levels of HbA1c and glycoalbumin were not high in the present case, however, obvious hyperglycemia was found even after the infection had completely healed. On reviewing 166 case of V. vulnificus infection in Japan including ours, the complication of diabetes mellitus, one of immunocompromised condition, was found only in 11%, although it had been reported that individuals strongly suspected of having diabetes were 17.2% among the Japanese male population aged from 40 to 74 years. Because diabetes mellitus might be underdiagnosed in the previous reports, intensive examinations are considered to be necessary in order to correctly diagnose diabetes mellitus in patients with severe V. vulnificus infection.

Development of an Indirect Sandwich ELISA for Detection of Duck Swollen Head Septicemia Virus

[Objective] To develop an indirect sandwich ELISA for rapid detection of duck swollen head septicemia virus （DSHSV）. [Method] DSHSV hyperimmune sara were prepared in ducks and rabbits by inoculation with DSHSV XD strain and then purified using saturated ammonium sulfate and Sephadex G-150 column chromatography to obtain anti-DSHSV IgG. An indirect sandwich ELISA was developed using the purified duck anti-DSHSV IgG and rabbit anti-DSHSV IgG after reaction conditions were optimized. Its specificity, sensitivity and repeatability were evaluated, and its accuracy was confirmed by observation with immunoelectron microscopy. Then, distribution of DSHSV in tissues of challenged ducks was also detected. [Result] Through optimizing conditions, the ELISA was developed. Only DSHSV could be detected by the developed method, but other pathogens could not be detected. Compared with agar gel diffusion test, the developed method was more sensitive. The coefficient of variation was less than 10%, and the developed method had good repeatability. In addition, the ELISA-positive samples contained DSHSV, as confirmed by im- munoelectron microscopy. All heart, liver, lung and kidney collected from the DSHSV-challenged ducks were positive when they were detected by the developed ELISA. [ Conclusion] The developed ELISA method is rapid, simple, specific and sensitive, and it is suitable for large-scale quaran- tine of DSHS. Heart, liver, lunq and kidney should be selected preferentially as specimens for diaclnosis of DSHS.

Value of serum PCT content for evaluating inflammatory factor release and organ function injury in neonatal septicemia

Objective: To explore the value of serum PCT content for evaluating inflammatory factor release and organ function injury in neonatal septicemia. Methods: 48 children who were diagnosed with neonatal septicemia in our hospital between March 2015 and May 2018 were selected as the septicemia group, and 50 healthy neonates delivered in our hospital during the same period were selected as the normal control group. The differences in PCT and inflammatory factor contents in serum as well as liver and kidney function index levels in peripheral blood were compared between the two groups. Pearson test was used to evaluate the correlation of serum PCT content with inflammatory factor release as well as liver and kidney function injury in children with neonatal septicemia. Results: The serum PCT content of septicemia group was significantly higher than that of normal control group;serum hypersensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), interleukin-8 (IL-8) and soluble intercellular adhesion molecule-1 (sICAM-1) contents were higher than those of normal control group;peripheral blood aspartate aminotransferase (AST), alanine aminotransferase (ALT), γ-glutamyl transpeptidase (γ-GGT) and alkaline phosphatase (ALP) levels were higher than those of normal control group;peripheral blood blood urea nitrogen (BUN), serum creatinine (Scr) and serum β2-microglobulin (β2-M) levels were higher than those of normal control group (P<0.05). Correlation analysis showed that serum PCT content in children with neonatal septicemia was directly correlated with the degree of inflammatory response as well as the degree of liver and kidney function injury (P<0.05). Conclusion: The serum PCT content abnormally increases in children with neonatal septicemia, and the specific content is consistent with the disease severity and has certain clinical value for the judgment of children's condition.

Value of PCT content for adjuvant diagnosis of neonatal septicemia and assessment of its severity

Objective:To evaluate the value of procalcitonin (PCT) content for adjuvant diagnosis of neonatal septicemia and assessment of its severity.Methods: A total of 100 newborns who were diagnosed with septicemia in the First People's Hospital of Xianyang City between January 2017 and January 2018 were selected as the septicemia group of the research, and the newborns who were born in the First People's Hospital of Xianyang City during the same period, with the general data matched with those of septicemia group and without neonatal diseases after born were selected as the control group. Serum was collected to determine the contents of PCT, inflammatory cytokines and immune cytokines, and peripheral blood was collected to determine the expression intensity of inflammatory signaling molecules and immune transcription factors.Results: Serum PCT, TNF-α, HMGB1, ICAM-1, IL-10 and IL-17 contents as well as peripheral blood TLR4, NF-κB, MPO, RORγt and FOXP3 expression intensity of septicemia group were significantly higher than those of control group whereas peripheral blood HLA-DR expression intensity was lower than that of control group;peripheral blood TLR4, NF-κB, MPO, RORγt and FOXP3 expression intensity as well as serum TNF-α, HMGB1, ICAM-1, IL-10 and IL-17 contents of septicemia group of newborns with high PCT were significantly higher than those of newborns with low PCT whereas peripheral blood HLA-DR expression intensity was lower than that of newborns with low PCT.Conclusion: The increase of PCT in serum of newborns with septicemia is related to the change of inflammatory response and immune response, and its content detection is valuable for assessing the severity of the disease.

Effect of Xingnaojing injection on intestinal mucosal barrier in septicemia and intracerebral hemorrhage mice

OBJECTIVE Xingnaojing injection(XNJ) is an extracts of Angong Niuhuang Pill that is a well-known traditional Chinese medicine used for the treatment of septicemia and stroke.This study aims to investigate the effect of XNJ on intestinal mucosal barrier in septicemia and intracerebral hem.orrhage(ICH) mice models.METHODS The septicemia mice models were induced by intravenous in.jection with lipopolysaccharide(20 mg·kg^(-1)).And the ICH mice models were made by intrastriatal injec.tion of bacterial collagenase.The septicemia animals were treated intravenously with XNJ at dose of2.5,5,10,or 15 mL·kg^(-1).The ICH animals were treated intravenously with XNJ at dose of 10 mL·kg^(-1).Thereafter,the permeability of intestinal mucosa was assayed by FITC-D method.RESULTS Com.pared with the control group(44.72±4.30),the permeability of intestinal mucosa in the mice in septice.mia group(233.68±28.18) was significantly increased(P<0.01).Treatment with XNJ at dose of 5,10,and 15 mL·kg^(-1) reduced the permeability of intestinal mucosa(150.45±17.52,139.21±17.05,132.55±18.88,respectively,P<0.01) except 2.5 mL·kg^(-1)(240.71±21.42,P>0.01);Compared with sham group(57.88±7.31),the permeability of intestinal mucosa in the mice of ICH(282.25±23.78) was significantly in.creased(P<0.01).Treatment with XNJ(10 mL·kg^(-1)) in the mice of ICH group ameliorated the change of permeability in intestinal mucosa(148.83±15.86,P<0.01).CONCLUSION XNJ exhibits the protec.tive effect on the intestinal mucosal barrier in septicemia and ICH,which will prevent the endotoxin to penetrate the intestinal mucosa and then to enter the circulation in infections and stress.

aEEG及NCIS预测早产儿败血症相关性脑病的比较

目的 比较振幅整合脑电图(aEEG)及新生儿危重病例评分(NCIS)预测早产儿败血症相关性脑病(SAE)的诊断价值。方法 选择2020年9月至2022年10月南京医科大学附属妇产医院新生儿重症监护病房(NICU)收治且病情最严重期间进行了aEEG监测的败血症早产儿为研究对象,根据SAE诊断标准,将47例败血症早产儿分为SAE组24例和非SAE组23例。两组败血症早产儿aEEG检查同时进行NCIS,比较两组患儿的一般资料、母孕期并发症、最差血气分析及aEEG监测时一般情况、疾病危重状况的差异,以及aEEG各参数的连续性、周期性、下边界振幅、带宽及总分和校正总分的差异。绘制SAE受试者工作特征(ROC)曲线,计算灵敏度、特异度和曲线下面积(AUC)。根据约登指数,比较NCIS和aEEG预测SAE的诊断价值。结果 两组败血症早产儿的一般资料、母孕期并发症、最差血气分析,及aEEG检查时的一般情况间的差异均无统计学意义(^(均)P>0.05),而NCIS、aEEG的连续性、周期性、下边界振幅、带宽、总分,均有统计学差异(^(均)P<0.05)。NCIS、aEEG的连续性、周期性、下边界振幅、带宽、aEEG总分,诊断SAE的AUC分别:0.727、0.726、0.884、0.706、0.849、0.890,约登指数分别0.406、0.703、0.703、0.412、0.746、0.701。结论 NCIS、aEEG连续性、周期性、带宽、总分,对诊断SAE有早期预测价值,aEEG比NCIS预测SAE效能更佳。

倍他米松磷酸钠注射液治疗早产有效性和安全性研究进展

倍他米松是地塞米松的同分异构体,具有抗炎、抗过敏、抗内毒素和免疫抑制等功能。倍他米松磷酸钠(BSP)注射液是倍他米松的磷酸盐制剂,作为一种糖皮质激素(ACS)类药物,其临床应用较广。BSP治疗早产已有充分的证据并被纳入各国指南,然而这些证据主要集中在高收入国家,中低收入国家相关证据则较少。我国关于BSP在产科应用疗效和安全性临床研究方面存在不足。关于倍他米松和地塞米松疗效和安全性直接比较的临床研究较少,BSP治疗早产后儿童期和成年期随访研究尚不足。因此,需进一步开展相关研究,为早产临床科学合理用药提供决策依据。

非O1/O139群霍乱弧菌致肝硬化失代偿期患者血流感染1例

患者,男性,58岁,乙型肝炎后肝硬化失代偿期、2型糖尿病12年,近1个月再发腹胀、水肿,尿少入院。住院期间患者寒战、发热,取血标本进行培养,选用头孢哌酮/舒巴坦经验性抗感染治疗。确诊非O1/O139霍乱弧菌引起的血流感染,药敏试验提示头孢哌酮/舒巴坦敏感后,继续使用当前药物,头孢哌酮/舒巴坦由3 g q12h改为3 g q8h治疗。10 d后患者无发热,血培养和粪便霍乱弧菌培养阴性,好转出院。

婴儿芽孢杆菌致新生儿败血症1例报告

本文报告一例婴儿芽孢杆菌所致新生儿败血症病例。患儿系34周^(+3)天早产儿,表现为发热,反应差,皮肤大理石花纹,呼吸急促,口吐泡沫,C反应蛋白、降钙素原增高明显,而血常规变化不大。外周血病原学微生物宏基因检出婴儿芽孢杆菌。予以青霉素和头孢噻肟舒巴坦联合抗感染、支持等治疗后病情好转出院,随访至10个月生长发育正常。婴儿芽孢杆菌属于芽孢杆菌属,可引起新生儿早发型败血症,国内暂无婴儿芽孢杆菌败血症的报道。新生儿感染婴儿芽孢杆菌起病急、病情较重,应早期行病原体检测,并给予积极有效的抗感染治疗。

α-Lipoic Acid Exerts Its Antiviral Effect against Viral Hemorrhagic Septicemia Virus(VHSV) by Promoting Upregulation of Antiviral Genes and Suppressing VHSV-Induced Oxidative Stress

Viral hemorrhagic septicemia virus(VHSV), belonging to the genus Novirhabdovirus, Rhabdoviridae family, is a causative agent of high mortality in fish and has caused significant losses to the aquaculture industry. Currently, no effective vaccines, Food and Drug Administration-approved inhibitors, or other therapeutic intervention options are available against VHSV. α-Lipoic Acid(LA), a potent antioxidant, has been proposed to have antiviral effects against different viruses. In this study, LA(CC_(50)= 472.6 lmol/L) was repurposed to exhibit antiviral activity against VHSV. In fathead minnow cells,LA significantly increased the cell viability post-VHSV infection(EC_(50)= 42.7 lmol/L), and exerted a dose-dependent inhibitory effect on VHSV induced-plaque, cytopathic effects, and VHSV glycoprotein expression. The time-of-addition assay suggested that the antiviral activity of LA occurred at viral replication stage. Survival assay revealed that LA could significantly upregulated the survival rate of VHSV-infected largemouth bass in both co-injection(38.095% vs. 1.887%,P < 0.01) and post-injection manner(38.813% vs. 8.696%, P < 0.01) compared with the control group. Additional comparative transcriptome and q RT-PCR analysis revealed LA treatment upregulated the expression of several antiviral genes, such as IRF7, Viperin, and ISG15. Moreover, LA treatment reduced VHSV-induced reactive oxygen species production in addition to Nrf2 and SOD1 expression. Taken together, these data demonstrated that LA suppressed VHSV replication by inducing antiviral genes expression and reducing VHSV-induced oxidative stress. These results suggest a new direction in the development of potential antiviral candidate drugs against VHSV infection.

病毒性出血性败血症病毒数字PCR检测方法的建立

为建立病毒性出血性败血症病毒精准快速检测方法,以病毒性出血性败血症病毒基因组特异保守的糖蛋白基因片段为靶目标,设计合成了特异性引物及探针,优化退火温度等关键反应条件,分别进行灵敏性试验、特异性试验及重现性试验,构建病毒性出血性败血症病毒数字PCR检测技术体系,同时,与实时荧光定量RT-PCR方法进行对比分析。试验结果显示,病毒性出血性败血症病毒数字PCR最佳退火温度为58.5℃。灵敏性试验显示,随着病毒性出血性败血症病毒基因组RNA连续10倍稀释,稀释至105倍数时,数字PCR体系仍可以检测到阳性微滴,因此,确定RNA基因组核酸含量19拷贝/μL为病毒性出血性败血症病毒数字PCR的检测低限。特异性试验表明,该方法只与目标病毒——病毒性出血性败血症病毒有特异性扩增,与传染性胰脏坏死病毒、传染性造血器官坏死病毒、鲤春病毒血症病毒、流行性造血器官坏死病毒、牙鲆弹状病毒、病毒性神经坏死病毒、锦鲤疱疹病毒、鲤浮肿病毒、真鲷虹彩病毒、淋巴囊肿病毒等10种病毒均无扩增反应。重复性试验结果表明,病毒性出血性败血症病毒数字PCR批内与批间试验的变异系数均小于1%,具备良好的重复性。利用构建的数字PCR方法,对收集到的国内及进境鱼类样品共计1210批次进行病毒性出血性败血症病毒检测,结果显示,数字PCR阳性样本检出率为9.5%,常规实时荧光定量RT-PCR阳性样本检出率为7.69%~7.77%。临床试验结果表明,研究建立的病毒性出血性败血症病毒数字PCR方法较常规技术具有更高的检测灵敏性,适用于水生动物疫病精准检测的需求。

Vibrio Septicemia Diagnosed With Next-Generation Sequencing:A Case Report

Vibrio vulnificus and Vibrio parahaemolyticus aremarine gram-negative bacilli that can cause septicemia and gastrointestinal and wound infections.Early suspicion,diagnosis and appropriate antibiotic therapy for those infections are essential as delay can adversely affect the outcome.Here,we report a patient who developed a V.vulnificus and V.parahaemolyticus infection after contact with a fishing net.The cause of infection was finally diagnosed by metagenomic next-generation sequencing.The patient required an emergency amputation of the upper-and middle-third of the right upper limb.

Cardiovascular characteristics of premature infants with Klebsiella Pneumoniae septicemia and shock

Background The cardiovascular characteristics during septic shock in premature neonates are characterized by elevated ventricular output and normal ejection fraction.However,there is little knowledge about other variables in premature infants with Klebsiella Pneumoniae(KPN)septicemia and shock.This study aimed to investigate the characteristics of cardiovascular changes in premature infants diagnosed with Klebsiella pneumonia(KPN)septicemia and shock.Methods Our study included premature infants(gestational age≤34 weeks)in the neonatal intensive care unit(NICU)of Guangdong Provincial People.s Hospital from November 1 st,2013 to November 31 st,2016.17 participants diagnosed with KPN septicemia complicated with shock and 17 healthy premature infants were respectively enrolled in study group and control group for analysis.All the infants underwent non-invasive ultrasound cardiac output monitor examinations in normal time,early stage of shock and cured time.Results Compared with the control group,higher values of heart rate(HR)(P<0.001),cardiac output index(CI)(P<0.001),Smith-Madigan inotropy index(SMII)(P<0.001)and oxygen delivery(DO2)(P<0.001),and lower levels of systemic vascular resistance index(SVRI)(P<0.001)were observed in the study group.The difference of mean blood pressure(MBP)was not statistically significant(P=0.943).In the study group,the values of HR(P=0.004),CI(P=0.004),SMII(P=0.004)and DO2(P=0.004)in the early stage of septic shock were significantly higher when compared with the values in the normal time,while the value of SVRI(P<0.001)was significantly lower.HR(P<0.001)and DO2(P=0.009)decreased from the early stage of septic shock to the cured time,while SVRI(P<0.001)increased.There were no significant changes in CI(P>0.999)and SMII(P=0.646)from early stage of septic shock to improvement in the study group.Conclusions Systemic vascular resistance index decreased and oxygen deliver elevated in preterm infants with gestational age less than 34 weeks with Klebsiella Pneumoniae septicemia and shock.Vasoregulatory failure may be the main cause of Klebsiella Pneumoniae septicemia and shock.Vasoactive drugs may be needed during shock.The increase of oxygen deliver level in the early stage of shock indicates that timely and effective vasoactive infusion can prevent the deterioration of the disease.

IL-6、IL-17、Th17与Treg在诊断新生儿败血症中的价值

目的 探讨外周血白细胞介素-6(IL-6)、IL-17、辅助性T细胞17(Th17)与调节性T细胞(Treg)在新生儿败血症治疗前后表达水平的变化。方法 收集2020年8月至2022年1月期间常德市第一人民医院的新生儿败血症患者86例作为观察组,129例新生儿非败血症患者作为对照组。检测患儿外周血中IL-6、IL-17、Th17、Treg、Th17/Treg的表达水平,比较上述指标在观察组治疗前后和对照组之间的差异,分析其在治疗前的相关性。结果 (1)观察组治疗前后和对照组的IL-6、Treg、Th17/Treg检测值的差异均具有统计学意义(H值分别为28.900、9.610、6.780,P<0.05)。(2)观察组早产儿治疗后的IL-6、IL-17、Th17/Treg水平均低于治疗前(Z值分别为-2.850、-2.150、-3.400,P<0.05);观察组早产儿治疗后的Treg水平高于治疗前(t=-2.440,P<0.05)。(3)观察组足月产儿治疗后的IL-6、Th17/Treg水平均低于治疗前(Z值分别为-4.570、-3.020,P<0.05),观察组足月产儿治疗后的Treg水平高于治疗前(Z=-2.640,P<0.05)。(4)观察组患儿治疗前外周血IL-6、IL-17与Th17表达水平呈正相关(r值分别为0.507、0.730,P<0.05);IL-6与Treg表达水平呈负相关(r=-0.336,P<0.05);IL-17与Treg表达水平无相关性(P>0.05)。结论 Th17与Treg细胞免疫平衡稳态的打破与新生儿败血症的发生发展密切相关。IL-6介导新生儿败血症Th17与Treg细胞免疫平衡稳态的打破。

美洲鳗鲡“脱黏败血综合征”病原的分离鉴定及其致病性研究

为明确美洲鳗鲡“脱黏败血综合征”的病原,本研究采集福建省某养殖场的美洲鳗鲡病料组织样品制备病理切片,观察各组织病变,结果显示,病鳗的鳃、肝脏和肾脏呈现广泛性红细胞渗出和组织细胞变性、坏死。将病料样品接种鳗鲡肾脏细胞系(EK)进行病毒的分离,对分离病毒经电镜观察,结果显示,接种病料样品匀浆液的EK细胞出现合胞体病变,可见细胞核内有大量直径约120 nm的病毒。提取病毒基因后作为模板,采用PCR鉴定,结果证实其为鳗鲡疱疹病毒(AngHV),将其命名为AngHV-20713。进一步扩增分离病毒的ORF71基因并分析其同源性和遗传进化关系,结果显示,AngHV-20713与其它AngHV的同源性为93.6%~99.0%,且与分离自美洲鳗鲡的AngHV亲缘关系最近。将分离病毒以106 pfu/尾腹腔注射健康的美洲鳗鲡和欧洲鳗鲡,进行人工感染实验,结果显示,AngHV-20713对鳗鲡具有致病性,感染鳗鲡可见体表黏液脱落、胸鳍出血等“脱黏败血综合征”症状,并导致美洲鳗鲡60%的发病率和20%的死亡率,而感染的欧洲鳗鲡死亡率高达56.7%。利用qPCR从感染病毒的美洲鳗鲡各组织内均可检测到AngHV,从内脏可再次分离培养到AngHV-20713,表明AngHV是美洲鳗鲡“脱黏败血综合征”的病原。本研究为深入开展鳗鲡“脱黏败血综合征”的防控研究奠定了基础。

Sepsis after Administering an Intramuscular Iron Injection in the Arm of an Elder Patient with Multiple Comorbidities: A Case Report

Background: Skin reactions and musculoskeletal injuries caused by intramuscular injection are an increased risk for skin and soft tissue infections and may culminate in sepsis. Objective: To describe the history of an elderly patient who developed a lesion in her right arm after home administration of intramuscular iron injection in this arm and its outcome. Methods: This is a case report of a patient who participated in a study in an intensive care unit. Results: This study describes a 65-year-old patient with multiple comorbidities who was admitted to the hospital complaining of pain for two months and difficulty in moving her right shoulder associated with skin and soft tissue infections in her right arm after intramuscular iron administration by a relative for the treatment of multifactorial anemia and refractory melena. The patient worsened her general condition and was transferred to the intensive care unit. Despite the therapy instituted, the patient developed sepsis of cutaneous origin, multiple organ dysfunction, and death. Conclusions: The administration of intramuscular medication requires the participation of qualified professionals, such as nurses, mainly within the scope of the Brazilian public health system which commonly comprises patients in a context of vulnerability.

Pathogenicity and Antimicrobial Resistance in Coagulase-Negative Staphylococci

The coagulase-negative staphylococci (CoNS) group was considered saprophytic or rarely pathogenic for many years. Since the first case of septicemia caused by CoNS, there has been a progressive increase in the prevalence of healthcare-associated infections caused by CoNS. The CoNS group has emerged as one of the main causes of nosocomial infections related to vascular catheters and prostheses, especially among immunocompromised patients. This gradual increase in infections is due to the change in the relationship between patients and procedures since CoNS are closely related to devices implanted in the human body. CoNS are successful in colonizing the host because they have several virulence mechanisms, such as biofilm formation and production of enzymes and toxins, in addition to several mechanisms of resistance to antimicrobials. Despite their great clinical relevance, few studies have focused on CoNS’s pathogenicity and resistance to antimicrobials, which reveals the current need to better understand the factors by which this group became pathogenic to humans and other animals. This review aims to synthesize the aspects related to the pathogenicity and antimicrobial resistance in CoNS.