Clinical significance of coagulase-negative staphylococci other than S. epidermidis blood stream isolates at a tertiary care hospital
- 732 Downloads
We retrospectively evaluated blood culture (BC) isolates of coagulase-negative staphylococci other than Staphylococcus epidermidis (NonSe-CoNS) for clinical relevance at a tertiary care hospital in Germany from January 2011 to September 2015.
Clinical data were correlated to microbiological results based on medical records. Infection was considered likely if (1) no other infection and (2) two or more isolates of the same species were present and (3) symptoms ameliorated after therapy. Infection was considered possible if a foreign body was present and (1) and (3) were fulfilled. All the other cases were considered contaminations.
313 patients with blood cultures positive for NonSe-CoNS were identified. 61 patients were excluded, either because of missing data or multiple pathogens in the same blood culture. Of the remaining 252 patients, 58 (23 %) were classified as possible (n = 32) or likely (n = 26) infections. S. haemolyticus was the most frequent isolate (infection: n = 28), followed by S. hominis (n = 13), S. capitis (n = 12), and S. lugdunensis (n = 3). One patient died from NonSe-CoNS infection. The source of infection in the majority of patients was foreign bodies (n = 43), and endocarditis was present in six cases. Staphylococci always considered contaminations were: S. auricularis, S. caprae, S. schleiferi, S. pettenkoferi, S. saccharolyticus, and S. simulans. The growth of NonSe-CoNS in the anaerobic BC bottle only and a time to positivity >36 h were associated with contaminations.
One out of four NonSe-CoNS isolates was clinically relevant in our cohort, where S. haemolyticus, S. capitis, S. hominis, and S. lugdunensis contributed to 96.6 % of all relevant infections.
KeywordsCoagulase-negative Staphylococci Bacteremia S. haemolyticus S. lugdunensis Blood culture Contamination
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 3.Diekema DJ, Pfaller MA, Schmitz FJ, Smayevsky J, Bell J, Jones RN, Beach M. Survey of infections due to Staphylococcus species: frequency of occurrence and antimicrobial susceptibility of isolates collected in the United States, Canada, Latin America, Europe, and the Western Pacific region for the SENTRY Antimicrobial Surveillance Program, 1997–1999. Clin Infect Dis. 2001;32(Suppl 2):S114–32. doi: 10.1086/320184.CrossRefPubMedGoogle Scholar
- 11.Mermel LA, Allon M, Bouza E, Craven DE, Flynn P, O’Grady NP, et al. Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 update by the infectious diseases society of America. Clin Infect Dis. 2009;49:1–45. doi: 10.1086/599376.CrossRefPubMedPubMedCentralGoogle Scholar
- 14.Haimi-Cohen Y, Shafinoori S, Tucci V, Rubin LG. Use of incubation time to detection in BACTEC 9240 to distinguish coagulase-negative staphylococcal contamination from infection in pediatric blood cultures. Pediatr Infect Dis J. 2003;22:968–74. doi: 10.1097/01.inf.0000095195.60494.ba.CrossRefPubMedGoogle Scholar
- 17.Kim SD, McDonald LC, Jarvis WR, McAllister SK, Jerris R, Carson LA, Miller JM. Determining the significance of coagulase-negative staphylococci isolated from blood cultures at a community 14 hospital: a role for species and strain identification. Infect Control Hosp Epidemiol. 2000;21:213–7. doi: 10.1086/501747.CrossRefPubMedGoogle Scholar
- 20.Chu VH, Cabell CH, Abrutyn E, Corey GR, Hoen B, Miro JM, et al. Native valve endocarditis due to coagulase-negative staphylococci: report of 99 episodes from the international collaboration on endocarditis merged database. Clin Infect Dis. 2004;39:1527–30. doi: 10.1086/424878.CrossRefPubMedGoogle Scholar
- 29.Aimoto M, Koh H, Katayama T, Okamura H, Yoshimura T, Koh S, et al. Diagnostic performance of serum high-sensitivity procalcitonin and serum C-reactive protein tests for detecting bacterial infection in febrile neutropenia. Infection. 2014;42:971–9. doi: 10.1007/s15010-014-0657-6.CrossRefPubMedGoogle Scholar