From the Guidelines
Coagulase-negative Staphylococci (CoNS) are not typically considered a primary cause of impetigo in premature infants, with the majority of cases attributed to Gram-positive bacteria such as Staphylococcus aureus and Streptococcus spp. According to the 2018 WSES/SIS-E consensus conference recommendations for the management of skin and soft-tissue infections 1, impetigo is predominantly caused by β-hemolytic Streptococcus spp. and/or S. aureus. While CoNS can be opportunistic pathogens in immunocompromised individuals, including premature infants, they are not commonly associated with impetigo. Key points to consider in the management of skin and soft-tissue infections in premature infants include:
- Impetigo is a highly contagious bacterial infection of the superficial layers of the epidermis, typically caused by Gram-positive bacteria 1
- Premature infants are vulnerable to infections due to their immature immune systems and thin skin barriers
- Treatment of impetigo typically involves antibiotics against Gram-positive bacteria, with consideration of the potential for community-acquired MRSA (CA-MRSA) 1
- Infection control measures, including proper hand hygiene and contact precautions, are crucial in preventing the spread of infection in premature infants. It is essential to note that while CoNS can cause infections in premature infants, they are not typically the primary cause of impetigo, and treatment should be guided by bacterial culture and susceptibility results to ensure appropriate antibiotic selection 1.
From the Research
Impetigo in Preemies
- Impetigo is a common bacterial skin infection that can affect individuals of all ages, including premature infants (preemies) 2, 3.
- The most common causes of impetigo are Staphylococcus aureus and Streptococcus pyogenes, with S. aureus being the primary cause of bullous impetigo 2, 3.
Coagulase-Negative Staphylococci (CoNS) and Impetigo
- CoNS are a type of bacteria that can cause infections, particularly in individuals with compromised immune systems or skin barriers 4, 5.
- While CoNS are not typically associated with impetigo, they can cause a range of other infections, including nosocomial infections and infections in immunocompromised individuals 4, 5.
- There is limited evidence to suggest that CoNS can cause impetigo in preemies, and the primary causes of impetigo in this population are still S. aureus and S. pyogenes 2, 3.
Treatment of Impetigo
- The treatment of impetigo typically involves the use of topical or oral antibiotics, such as mupirocin, retapamulin, and fusidic acid 2, 3, 6.
- The choice of antibiotic should be guided by the results of antimicrobial susceptibility testing and the presence of any antibiotic resistance patterns 6.
- In cases where CoNS are suspected or confirmed to be the cause of impetigo, treatment with antibiotics such as vancomycin or linezolid may be considered, although the efficacy of these agents against CoNS can vary 4, 5.