Epidemiological Comparison of True Methicillin-Resistant and Methicillin-Susceptible Coagulase-Negative Staphylococcal Bacteremia at Hospital Admission

Abstract

We performed 2 case-control studies among 108 patients with true coagulase-negative staphylococcal (CoNS) bacteremia diagnosed within 48 h of hospital admission. Seventy-nine patients (73%) with methicillin-resistant (MR) CoNS bacteremia and 29 patients (27%) with methicillin-susceptible (MS) CoNS bacteremia were compared with 79 randomly selected control patients without CoNS bacteremia. The presence of a central venous catheter was an independent risk factor for both MR- and MS-CoNS bacteremia (P<.001). Patients with MR-CoNS bacteremia were more frequently admitted from health care facilities (P=.02), more likely to have had previous MR Staphylococcus aureus infection or colonization (P=.02), and more likely to have received antibiotics in the previous 30 days (P=.02). The probability that bacteremia was caused by an MR strain, rather than an MS strain, was 62% among patients admitted from the community and 84% among patients admitted from health care facilities. This study identified epidemiological characteristics that can be used to distinguish between MR- and MS-CoNS bacteremia and found high rates of methicillin resistance among CoNS isolates recovered from patients admitted from the community, as well as from health care facilities.

Molecular epidemiology of meticillin-resistant coagulase-negative staphylococci in a Swedish county hospital: evidence of intra- and interhospital clonal spread

“…Firstly, the investigation was restricted to meticillin-resistant CNS, as antimicrobial resistance is a marker for nosocomial strains, thereby excluding the possibility of detecting genetically closely related meticillin-sensitive CNS. 21 Secondly, the primary aim of the study was to detect putative clonal spread of CNS within the county hospital and not to evaluate the clinical relevance of analysed isolates. However, several clinically significant infections caused by multi-drug-resistant CNS were observed in the study.…”

Antibiotic Usage and Risk of Colonization and Infection with Antibiotic-Resistant Bacteria: a Hospital Population-Based Study

“…Meta-analyses have documented that bloodstream infection caused by methicillin (meticillin)-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), extended-spectrum ␤-lactamase-producing Enterobacteriaceae, and multidrug-resistant Acinetobacter baumannii are associated significantly with mortality (7,9,11,24). Numerous papers have demonstrated that prior antimicrobial drug exposure is a strong risk factor for colonization and infection due to a drug-resistant pathogen (2,25,27). However, the association between antibiotic therapy and the acquisition of antibiotic-resistant bacteria (ARB) is still unclear and is often confounded by scarce data on antibiotic usage.…”

Comparison of Demographic and Some Clinical Features of Patients Whose Blood Cultures Revealed Growth of Coagulase Negative Staphylococci and Differentiation Between Infectious Agent and Contaminant was Performed According to the CDC Criteria

“…Yeterli sayıda kan kültürü gönderilme-yen hastalarda, hastanın doktorunun ya da enfeksiyon kontrol ekibi doktorunun hastada sepsis bulgularının varlığını düşünmesi ve başka enfeksiyon odağının bulunmaması etkenin gerçek bakteriyemi etkeni olarak değerlendirilmesini sağladı. Çalışmamıza benzer şekilde daha önce yapılan farklı çalışmalarda, tek set kan kültüründe KNS üremesinin her zaman kontaminant olarak değerlendirilmemesi gerektiği bildirilmiş (9,10) ve bu nedenle CDC kriterlerinin klinik tanıdaki yerinin sorgulanması önerilmiştir.…”

“…Tacconelli ve ark. (9) çalışmalarında, santral venöz kateter varlığını hem metisiline dirençli KNS bakteriyemisi, hem de metisiline duyarlı KNS bakteriyemisi için risk faktörü olarak ortaya koymuşlardır.…”