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  • Clinical outcomes of Staphylococcus capitis isolation from neonates, England, 2015–2021: a retrospective case–control study

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Original research
Clinical outcomes of Staphylococcus capitis isolation from neonates, England, 2015–2021: a retrospective case–control study
  1. Jin-Min Yuan1,
  2. Christopher Nugent2,
  3. Allegra Wilson1,
  4. Neville Q Verlander3,
  5. Eliza Alexander1,
  6. Paul Fleming4,5,
  7. Neena Modi6,7,
  8. Kayleigh Oughham6,
  9. Natasha Ratnaraja8,
  10. Yu Wan9,10,
  11. Louise Thorn9,
  12. Heather Felgate11,
  13. Mark A Webber11,
  14. Enitan Ogundipe7,12,
  15. Colin S Brown9,10,
  16. Karthik Paranthaman1,
  17. Alicia Demirjian9,10,12,13,14
  1. 1 Field Service, UK Health Security Agency, London, UK
  2. 2 UK Field Epidemiology Training Programme, UK Health Security Agency, Belfast, UK
  3. 3 Statistics Unit, Statistics, Modelling and Economics Department, UK Health Security Agency, London, UK
  4. 4 Homerton Healthcare NHS Foundation Trust, London, UK
  5. 5 Queen Mary University of London, London, UK
  6. 6 Section of Neonatal Medicine, Imperial College London, London, UK
  7. 7 Chelsea and Westminster Healthcare NHS Trust, London, UK
  8. 8 University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
  9. 9 Healthcare-Associated Infection, Fungal, Antimicrobial Resistance, Antimicrobial Use and Sepsis Division, UK Health Security Agency, London, UK
  10. 10 NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Department of Infectious Disease, Imperial College London, London, UK
  11. 11 Quadram Institute Bioscience, Norwich, UK
  12. 12 Faculty of Medicine, Imperial College London, London, UK
  13. 13 Department of Paediatric Infectious Diseases and Immunology, Evelina London Children's Hospital, London, UK
  14. 14 Faculty of Life Sciences and Medicine, King's College London, London, UK
  1. Correspondence to Dr Jin-Min Yuan, Field Service, UK Health Security Agency, London, SE1 8UG, UK; JinMin.Yuan{at}ukhsa.gov.uk

Abstract

Objective Staphylococcus capitis, a coagulase-negative staphylococci (CoNS) species, has been increasingly detected from UK sterile site samples and has caused neonatal unit outbreaks worldwide. We compared survival to discharge and 30-day mortality for the detection of S. capitis versus other CoNS species.

Methods In this retrospective case–control study, we included hospitalised infants with any CoNS species detected from a normally sterile body site up to 90 days of age. We linked English laboratory reports from the Second Generation Surveillance System database, mortality data from the Personal Demographics Service, and neonatal unit admissions from the National Neonatal Research Database. In primary analysis, multivariable logistic regression was used, with two co-primary outcomes: survival to discharge and death within 30 days of positive specimen date. Sensitivity analyses using multiply imputed datasets followed.

Results We identified 16 636 CoNS episodes relating to 13 745 infants. CoNS episodes were highest among infants born extremely preterm (22–27 weeks) and with extremely low birth weight (400–999 g). In primary analysis, there were no differences in survival to discharge (p=0.71) or 30-day mortality (p=0.77) between CoNS species. In sensitivity analyses, there were no differences in outcomes between infection with four of the most common CoNS species (Staphylococcus epidermidis, S. capitis, Staphylococcus haemolyticus and Staphylococcus warneri) but the remaining CoNS species were at higher risk of adverse outcomes when treated in aggregate.

Conclusion Infants with S. capitis detected from sterile site samples did not experience significant differences in either survival to discharge or 30-day mortality compared with infants with detection of other common CoNS species.

  • Communicable Diseases
  • Neonatology
  • Intensive Care Units, Neonatal

Data availability statement

Data are available upon reasonable request. UKHSA operates a robust governance process for applying to access protected data. Further details can be found at https://www.gov.uk/government/publications/accessing-ukhsa-protected-data/accessing-ukhsa-protected-data.

https://doi.org/10.1136/archdischild-2023-325887

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    Data availability statement

    Data are available upon reasonable request. UKHSA operates a robust governance process for applying to access protected data. Further details can be found at https://www.gov.uk/government/publications/accessing-ukhsa-protected-data/accessing-ukhsa-protected-data.

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    Footnotes

    • KP and AD are joint senior authors.

    • Twitter @NeenaModi1, @bluebirdsjunk

    • Contributors CN, KP, NQV, CSB and AD conceived and designed the study. CN, EA, PF, NM, KO, NR, YW, LT, HF, MAW and EO contributed to the study design. KP, AW, and J-MY performed the data analysis and interpreted the results. NQV provided advice on statistical methods. KP and J-MY drafted the manuscript. All authors reviewed the manuscript and approved the final version for publication. KP is the guarantor.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests YW is an Imperial Institutional Strategic Support Fund Springboard Research Fellow, funded by the Wellcome Trust and Imperial College London. YW, AD and CSB are affiliated with the National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at Imperial College London in partnership with the UK Health Security Agency (formerly Public Health England), in collaboration with Imperial Healthcare Partners, University of Cambridge and University of Warwick.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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