scholarly journals Laboratory markers to determine clinical significance of coagulase-negative staphylococci in blood cultures

Critical Care ◽  
2007 ◽  
Vol 11 (Suppl 4) ◽  
pp. P27
Author(s):  
Piret Mitt ◽  
Siiri Kõljalg ◽  
Krista Lõivukene ◽  
Epp Sepp ◽  
Irja Lutsar ◽  
...  
Keyword(s):  
Clinical Significance ◽  
Blood Cultures ◽  
Coagulase Negative Staphylococci ◽  
Laboratory Markers

The clinical significance of coagulase-negative staphylococci-positive blood cultures

2004 ◽  
Vol 44 (4) ◽  
pp. S125
Author(s):  
S.E. Beekmann ◽  
D.J. Diekema ◽  
E.W. Dickson ◽  
G.V. Doerm
Keyword(s):  
Clinical Significance ◽  
Blood Cultures ◽  
Coagulase Negative Staphylococci

Determining the Clinical Significance of Coagulase-Negative Staphylococci Isolated From Blood Cultures

2005 ◽  
Vol 26 (6) ◽  
pp. 559-566 ◽  
Author(s):  
Susan E. Beekmann ◽  
Daniel J. Diekema ◽  
Gary V. Doern
Keyword(s):  
Clinical Significance ◽  
Clinical Evidence ◽  
Tertiary Care ◽  
Laboratory Data ◽  
Bloodstream Infections ◽  
Sepsis Syndrome ◽  
Blood Cultures ◽  
Coagulase Negative Staphylococci ◽  
Inappropriate Use

AbstractBackground and Objective:Coagulase-negative staphylococci are both an important cause of nosocomial bloodstream infections and the most common contaminants of blood cultures. Judging the clinical significance of coagulase-negative staphylococci is vital but often difficult and can have a profound impact on an institution's bloodstream infection rates. Our objective was to develop an algorithm to assist in determining the clinical significance of coagulase-negative staphylococci.Design:A single experienced reviewer examined the medical records of 960 consecutive patients with positive blood cultures in a tertiary-care referral teaching hospital. Four hundred five of the cultures contained coagulase-negative staphylococci. A determination of clinical significance was made and the performances of various published algorithms that contained readily available clinical and laboratory data were compared.Results:Eighty-nine (22%) of the episodes were considered significant, whereas 316 were contaminants. Patients with bacteremia were significantly more likely to be neutropenic and exhibit signs of sepsis syndrome. The algorithm with the best combined sensitivity (62%) and specificity (91%) for determining the clinical significance of coagulase-negative staphylococci was defined as at least two blood cultures positive for coagulase-negative staphylococci within 5 days, or one positive blood culture plus clinical evidence of infection, which includes abnormal white blood cell count and temperature or blood pressure.Conclusion:Use of this algorithm could potentially reduce misclassification of nosocomial bloodstream infections and inappropriate use of vancomycin for positive blood cultures likely to represent contamination (Infect Control Hosp Epidemiol2005;26:559-566).

Nosocomial Bacteremia Clinical Significance of a Single Blood Culture Positive for Coagulase-Negative Staphylococci

2005 ◽  
Vol 26 (8) ◽  
pp. 697-702 ◽  
Author(s):  
Benoît Favre ◽  
Stéphane Hugonnet ◽  
Luci Correa ◽  
Hugo Sax ◽  
Peter Rohner ◽  
...  
Keyword(s):  
Blood Culture ◽  
Clinical Significance ◽  
Positive Blood Culture ◽  
Blood Cultures ◽  
University Teaching ◽  
Coagulase Negative Staphylococci ◽  
Nosocomial Bacteremia ◽  
Single Positive ◽  
Clinically Significant ◽  
Culture Positive

AbstractObjectives:To describe the epidemiology of nosocomial coagulase-negative staphylococci (CoNS) bacteremia and to evaluate the clinical significance of a single blood culture positive for CoNS.Design:A 3-year retrospective cohort study based on data prospectively collected through hospital-wide surveillance. Bacteremia was defined according to CDC criteria, except that a single blood culture growing CoNS was not systematically considered as a contaminant. All clinically significant blood cultures positive for CoNS nosocomial bacteremia were considered for analysis.Setting:A large university teaching hospital in Geneva, Switzerland.Results:A total of 2,660 positive blood cultures were identified. Of these, 1,108 (41.7%) were nosocomial; CoNS were recovered from 411 nosocomial episodes (37.1%). Two hundred thirty-four episodes of CoNS bacteremia in the presence of signs of sepsis were considered clinically relevant and analyzed. Crude mortality and associated mortality were 24.4% and 12.8%, respectively. Associated mortality was similar among patients with one positive blood culture and those with two or more (16.2% vs 10.8%, respectively;P= .3). Mortality rates after bacteremia for patients with a single positive blood culture and for those with two or more were 15.3% and 7.0%, respectively, at day 14 (RR, 2.2; CI%, 0.87-5.46) and 20.8% and 11.3%, respectively, at day 28 (RR, 1.9; CI95, 0.9-3.8). On multivariate analysis, only age and a rapidly fatal disease were independently associated with death.Conclusion:CoNS bacteremia harbor a significant mortality and a single positive blood culture in the presence of signs of sepsis should be considered as clinically relevant.

scholarly journals Is There Clinical Significance to Coagulase-Negative Staphylococci Isolated from Blood Cultures?

2017 ◽  
Vol 22 (1) ◽  
pp. 34-41
Author(s):  
Şebnem ÇALIK ◽  
Selma TOSUN ◽  
Ümmügülsüm ALTIN ◽  
Alpay ARI ◽  
Ali Ilgın OLUT ◽  
...  
Keyword(s):  
Clinical Significance ◽  
Blood Cultures ◽  
Coagulase Negative Staphylococci

Determination of clinical significance of coagulase-negative staphylococci in blood cultures

2017 ◽  
Vol 87 (3) ◽  
pp. 291-294 ◽  
Author(s):  
Asiye Karakullukçu ◽  
Mert Ahmet Kuşkucu ◽  
Sevgi Ergin ◽  
Gökhan Aygün ◽  
Kenan Midilli ◽  
...  
Keyword(s):  
Clinical Significance ◽  
Blood Cultures ◽  
Coagulase Negative Staphylococci

scholarly journals 577. Incidence and Outcomes of Positive Outpatient Surveillance Blood Cultures in Hematopoietic Stem Cell Transplant (HSCT) Patients with Graft Versus Host Disease (GvHD) On High Dose ≥ 0.5 mg/kg/day (HD) and Low Dose < 0.5mg/kg/day (LD) Steroid Therapy

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S353-S354
Author(s):  
Sarah Perreault ◽  
Molly Schiffer ◽  
Jennifer Zhao ◽  
Dayna McManus ◽  
Francine Foss ◽  
...  
Keyword(s):  
Steroid Therapy ◽  
Central Line ◽  
Blood Cultures ◽  
High Dose ◽  
Cell Transplant ◽  
Coagulase Negative Staphylococci ◽  
Hematopoietic Stem ◽  
Surveillance Cultures ◽  
Number Of Patients ◽  
Clinically Significant

Abstract Background Treatment of GvHD with steroids increases the risk of infection in HSCT patients due to additive immunosuppression and may delay the diagnosis of infection due to lack of symptoms. Outpatient surveillance blood cultures in HSCT with GvHD being treated with HD steroids has demonstrated a blood culture positivity rate of 3.5%. Currently, the utility of surveillance cultures in patients receiving LD steroid therapy is unknown. Our practice includes weekly outpatient surveillance cultures for all GvHD patients treated with steroids regardless of the dose. The primary endpoint of this study was to assess the incidence of positive surveillance blood cultures in GvHD patients receiving HD or LD steroids. Secondary endpoints included number of patients treated, hospitalization, 30 day mortality due to infection, and organisms isolated. Methods This was a single-center, retrospective review of GvHD patients at Yale New Haven Hospital between January 2013 and May 2019. Patients were excluded if: lack of signs or symptoms of GvHD, treatment with steroids for any indication other than GvHD, and active GvHD without central line. Cultures from patients receiving antibiotics for concurrent infection were also excluded. Results A total of 71 patients met criteria with 901 blood cultures. On HD, eight patients (14%) had 12 positive cultures (4%), and on LD, 16 patients (25%) had 22 positive cultures (4%) (p=0.15). Treatment occurred in six patients (75%) with four (24%) requiring hospitalization on HD, and 12 patients (75%) with 10 (83%) requiring hospitalization on LD (p=0.45). The median duration of steroid therapy was 93 and 236 days with a median dose of steroids of 1mg/kg/day and 0.15mg/kg/day, respectively. The number of positive cultures/1000 steroid days was 1.2 on HD and 0.5 on LD (RR 2.2). 30 day mortality was only noted in one patient (8%) on LD. The most common organism in both groups was Coagulase-negative staphylococci with all six cultures on HD classified as contaminants and 6/10 cultures requiring treatment on LD. Conclusion Although the relative risk of positive surveillance blood cultures in HD patients compared to LD was twofold higher, there were clinically significant infections identified in the LD group. Disclosures All Authors: No reported disclosures

Distinguishing Sepsis From Blood Culture Contamination in Young Infants With Blood Cultures Growing Coagulase-Negative Staphylococci

PEDIATRICS ◽  
1990 ◽  
Vol 86 (2) ◽  
pp. 157-162
Author(s):  
Joseph W. St Geme ◽  
Louis M. Bell ◽  
Stephen Baumgart ◽  
Carl T. D'Angio ◽  
Mary Catherine Harris
Keyword(s):  
Blood Culture ◽  
Peripheral Blood ◽  
Clinical Information ◽  
Study Groups ◽  
Blood Cultures ◽  
High Risk Population ◽  
Coagulase Negative Staphylococci ◽  
Peripheral Blood Culture ◽  
Young Infants ◽  
Initial Culture

Coagulase-negative staphylococci represent the most common cause of serious nosocomial infection in many intensive care nurseries. However, these organisms are also common blood culture contaminants. To determine the value of quantitative blood cultures in distinguishing sepsis from culture contamination, we reviewed records of all infants in our nurseries who had peripheral blood isolates of coagulase-negative staphylococci during a 3-year period. Twenty-three episodes of sepsis were identified in 21 infants, and 10 infants had blood culture contamination. Colony counts from the initial peripheral blood culture were significantly different for the two study groups (P &lt; .001). In 9 of 23 episodes of sepsis, the initial peripheral blood culture grew &gt;100 colony-forming units (cfu) per mL. In the other 14 episodes, the initial culture yielded ≤50 cfu/mL. All 10 infants with culture contamination had colony counts of &lt;50 cfu/mL, and in 9 the initial peripheral blood culture grew &lt;20 cfu/mL. Infants with sepsis, including those with colony counts of ≤50 cfu/mL, were significantly more likely to have a central catheter or an abnormal hematologic value or both (P &lt; .05). Infants who lacked these clinical features were more likely to have contamination. We conclude that quantitative blood cultures in conjunction with specific clinical information may distinguish sepsis from culture contamination with coagluase-negative staphylococci in young infants. In addition, low colony-count growth should not be ignored as contamination in this high-risk population.

Sign in / Sign up

Export Citation Format

Share Document