Skip to main content
CMAJ : Canadian Medical Association Journal logoLink to CMAJ : Canadian Medical Association Journal
. 1987 Jul 15;137(2):121–125.

Septicemia due to coagulase-negative Staphylococcus in a community hospital.

J Righter
PMCID: PMC1492648  PMID: 3594342

Abstract

The experience with septicemia due to coagulase-negative Staphylococcus at a 623-bed primary care hospital between 1980 and 1984 was reviewed. A total of 38 episodes in 37 patients were documented; data were available on 37 episodes in 36 patients. The organism accounted for 3.8% of all cases of septicemia and 6.7% of cases of nosocomial septicemia and was associated with 0.03% of all admissions. The incidence remained stable over the 5 years. The rate of survival 28 days after the episode was 78%. Most of the episodes (31) originated from infected vascular access sites. Of the 37 isolates 15 (41%), all S. epidermidis, were slime producing. S. epidermidis accounted for 33 of the isolates; of the 33, 5 were methicillin-resistant and slime producing. Various in-vitro susceptibility testing methods and testing for beta-lactamase production yielded conflicting results. Methicillin resistance, slime production and speciation as S. epidermidis were not confirmed as virulence markers. Five patients with methicillin-resistant organisms were treated with cephalosporins, and all recovered. These findings as well as examination of the literature do not support the recommendations that laboratories report such isolates as resistant to all beta-lactam agents and that vancomycin be given in all such infections. The different case mix in community hospitals as compared with university centres results in different patterns of nosocomial infection. Since the community hospital patient population is much larger, more information on the patterns of infections in these centres is needed.

Full text

PDF
124

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Baddour L. M., Smalley D. L., Kraus A. P., Jr, Lamoreaux W. J., Christensen G. D. Comparison of microbiologic characteristics of pathogenic and saprophytic coagulase-negative staphylococci from patients on continuous ambulatory peritoneal dialysis. Diagn Microbiol Infect Dis. 1986 Sep;5(3):197–205. doi: 10.1016/0732-8893(86)90002-7. [DOI] [PubMed] [Google Scholar]
  2. Burchard K. W., Minor L. B., Slotman G. J., Gann D. S. Staphylococcus epidermidis sepsis in surgical patients. Arch Surg. 1984 Jan;119(1):96–100. doi: 10.1001/archsurg.1984.01390130078014. [DOI] [PubMed] [Google Scholar]
  3. Christensen G. D., Bisno A. L., Parisi J. T., McLaughlin B., Hester M. G., Luther R. W. Nosocomial septicemia due to multiply antibiotic-resistant Staphylococcus epidermidis. Ann Intern Med. 1982 Jan;96(1):1–10. doi: 10.7326/0003-4819-96-1-1. [DOI] [PubMed] [Google Scholar]
  4. Christensen G. D., Parisi J. T., Bisno A. L., Simpson W. A., Beachey E. H. Characterization of clinically significant strains of coagulase-negative staphylococci. J Clin Microbiol. 1983 Aug;18(2):258–269. doi: 10.1128/jcm.18.2.258-269.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Christensen G. D., Simpson W. A., Bisno A. L., Beachey E. H. Adherence of slime-producing strains of Staphylococcus epidermidis to smooth surfaces. Infect Immun. 1982 Jul;37(1):318–326. doi: 10.1128/iai.37.1.318-326.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Gill V. J., Selepak S. T., Williams E. C. Species identification and antibiotic susceptibilities of coagulase-negative staphylococci isolated from clinical specimens. J Clin Microbiol. 1983 Dec;18(6):1314–1319. doi: 10.1128/jcm.18.6.1314-1319.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Hutton J. P., Hamory B. H., Parisi J. T., Strausbaugh L. J. Staphylococcus epidermidis arthritis following catheter-induced bacteremia in a neutropenic patient. Diagn Microbiol Infect Dis. 1985 Mar;3(2):119–124. doi: 10.1016/0732-8893(85)90020-3. [DOI] [PubMed] [Google Scholar]
  8. Ishak M. A., Gröschel D. H., Mandell G. L., Wenzel R. P. Association of slime with pathogenicity of coagulase-negative staphylococci causing nosocomial septicemia. J Clin Microbiol. 1985 Dec;22(6):1025–1029. doi: 10.1128/jcm.22.6.1025-1029.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Jay S. J. Nosocomial infections. Med Clin North Am. 1983 Nov;67(6):1251–1277. doi: 10.1016/s0025-7125(16)31152-x. [DOI] [PubMed] [Google Scholar]
  10. Karchmer A. W., Archer G. L., Dismukes W. E. Staphylococcus epidermidis causing prosthetic valve endocarditis: microbiologic and clinical observations as guides to therapy. Ann Intern Med. 1983 Apr;98(4):447–455. doi: 10.7326/0003-4819-98-4-447. [DOI] [PubMed] [Google Scholar]
  11. Lowy F. D., Hammer S. M. Staphylococcus epidermidis infections. Ann Intern Med. 1983 Dec;99(6):834–839. doi: 10.7326/0003-4819-99-6-834. [DOI] [PubMed] [Google Scholar]
  12. Ponce de Leon S., Wenzel R. P. Hospital-acquired bloodstream infections with Staphylococcus epidermidis. Review of 100 cases. Am J Med. 1984 Oct;77(4):639–644. doi: 10.1016/0002-9343(84)90354-1. [DOI] [PubMed] [Google Scholar]
  13. Sewell C. M., Clarridge J. E., Young E. J., Guthrie R. K. Clinical significance of coagulase-negative staphylococci. J Clin Microbiol. 1982 Aug;16(2):236–239. doi: 10.1128/jcm.16.2.236-239.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Wade J. C., Schimpff S. C., Newman K. A., Wiernik P. H. Staphylococcus epidermidis: an increasing cause of infection in patients with granulocytopenia. Ann Intern Med. 1982 Oct;97(4):503–508. doi: 10.7326/0003-4819-97-4-503. [DOI] [PubMed] [Google Scholar]
  15. Winston D. J., Dudnick D. V., Chapin M., Ho W. G., Gale R. P., Martin W. J. Coagulase-negative staphylococcal bacteremia in patients receiving immunosuppressive therapy. Arch Intern Med. 1983 Jan;143(1):32–36. [PubMed] [Google Scholar]

Articles from CMAJ: Canadian Medical Association Journal are provided here courtesy of Canadian Medical Association

RESOURCES