Hospital-acquired bloodstream infections with Staphylococcus epidermidis: Review of 100 cases

León, Samuel Ponce de; Wenzel, R. P.

doi:10.1016/0196-6553(85)90109-9

Cited by 21 publications

(29 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A frequently referenced paper urges caution before calling a single positive blood culture a contaminant after no difference in hypothermia, fever, leukocytosis, or mortality was found in patients with CNS in one bottle versus two or more bottles (12). That study used the number of positive single bottles rather than culture sets as the basis for comparison, and the exact number of patients with a single bottle positive was not reported but was less than 16 (12). The study design and small patient sample make it difficult to use the data (12) as an argument against our algorithm's automatic classification of a single positive blood culture with additional negative cultures as a contaminant.…”

Section: Discussionmentioning

confidence: 99%

“…The study design and small patient sample make it difficult to use the data (12) as an argument against our algorithm's automatic classification of a single positive blood culture with additional negative cultures as a contaminant. Some of the patients with one bottle positive only had one set of cultures drawn (12). The significance of these cultures would be evaluated by a pathology resident according to our algorithm.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Minimizing the Workup of Blood Culture Contaminants: Implementation and Evaluation of a Laboratory-Based Algorithm

et al. 2002

View full text Add to dashboard Cite

An algorithm was implemented in the clinical microbiology laboratory to assess the clinical significance of organisms that are often considered contaminants (coagulase-negative staphylococci, aerobic and anaerobic diphtheroids, Micrococcus spp., Bacillus spp., and viridans group streptococci) when isolated from blood cultures. From 25 August 1999 through 30 April 2000, 12,374 blood cultures were submitted to the University of Iowa Clinical Microbiology Laboratory. Potential contaminants were recovered from 495 of 1,040 positive blood cultures. If one or more additional blood cultures were obtained within ؎48 h and all were negative, the isolate was considered a contaminant. Antimicrobial susceptibility testing (AST) of these probable contaminants was not performed unless requested. If no additional blood cultures were submitted or there were additional positive blood cultures (within ؎48 h), a pathology resident gathered patient clinical information and made a judgment regarding the isolate's significance. To evaluate the accuracy of these algorithm-based assignments, a nurse epidemiologist in approximately 60% of the cases performed a retrospective chart review. Agreement between the findings of the retrospective chart review and the automatic classification of the isolates with additional negative blood cultures as probable contaminants occurred among 85.8% of 225 isolates. In response to physician requests, AST had been performed on 15 of the 32 isolates with additional negative cultures considered significant by retrospective chart review. Agreement of pathology resident assignment with the retrospective chart review occurred among 74.6% of 71 isolates. The laboratory-based algorithm provided an acceptably accurate means for assessing the clinical significance of potential contaminants recovered from blood cultures.False-positive blood cultures lead to additional laboratory tests, unnecessary antibiotic use, and longer hospitalizations that increase patient care costs (2, 16). Assessing the clinical significance of blood culture isolates can be difficult, but actions based on the accurate identification of contaminants may minimize the associated costs and lower future contaminant rates. An algorithm was implemented in the University of Iowa Clinical Microbiology Laboratory to assess the clinical significance of organisms that are often considered contaminants when isolated from blood cultures. An independent retrospective chart review was used to assess the accuracy of automatic assignments made by the algorithm, determinations of clinical significance by pathology residents, and the reclassification of probable contaminant isolates as pathogens after physicians requested antimicrobial susceptibility testing (AST).(This report was presented in part at the 101st General Meeting of the American Society for Microbiology, 21 May 2001 [abstr. C-65].) MATERIALS AND METHODSFrom 25 August 1999 through 30 April 2000, 12,374 blood culture sets were submitted to the University of Iowa Clinical Microbiology Laboratory....

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Minimizing the Workup of Blood Culture Contaminants: Implementation and Evaluation of a Laboratory-Based Algorithm

et al. 2002

View full text Add to dashboard Cite

show abstract

“…Olguların 39 (%55. [15][16][17][18] . Ancak çalışmalarda eşlik eden hastalıkların KNS bakteremilerinde risk faktörü olarak ön plana çıkmadığı dikkati çekmektedir.…”

Section: İstatistiksel Analizunclassified

“…KNS infeksiyonlarının tedavisinde metisilin direnci, tedavi seçeneklerinin kısıtlılığına yol aç-maktadır [14][15][16][17][18][19][20] . Çalışmamızda KDİ etkenlerinin %77.8'i metisiline dirençli bulunmuştur.…”

Section: İstatistiksel Analizunclassified

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

Çalık¹,

Tosun²,

Altin³

et al. 2017

FLORA

View full text Add to dashboard Cite

show abstract

“…Immunocompromised hosts, such as neonates and oncology patients, with indwelling prosthetic devices are especially susceptible to infection with CNS. [1][2][3] The bacterial cell surface may be considered as a mosaic structure, allowing all major components to interact with external factor^.^ In S. aureus infections, peptidoglycan (PG), teichoic acid (TA), lipoteichoic acid (LTA), protein A and other cell-wall components were shown to play an important role in pathogenesis.…”

Section: Introductionmentioning

confidence: 99%

Chemiluminescence of human polymorphonuclear leucocytes after stimulation with whole cells and cell-wall components of Staphylococcus epidermidis

Martínez-Martínez

Timmerman²,

Fleer³

et al. 1993

Journal of Medical Microbiology

View full text Add to dashboard Cite

Summary. The purpose of this study was to define cell-wall components of Staphylococcus epidermidis responsible for activation of human polymorphonuclear leucocytes (PMNL). Metabolic activation of PMNL was determined by chemiluminescence (CL). Purified peptidoglycan (PG) induced a concentration-dependent metabolic burst in PMNL. The minimal concentration needed for CL induction was 1 pglml. Comparison between different S. epidermidis strains showed variation in the capacity to induce CL in PMNL. Purified PG induced a higher CL response in PMNL than its intact parent strain; this effect was found in all S. epidermidis strains. Lipoteichoic acid (LTA), PG stem peptide and muramyldipeptide (MDP) did not induce CL; teichoic acid induced a CL response only at very high concentrations. No differences in CL inducing capacity were found between PG, crude cell walls, and purified cell walls of S. epidermidis. Sonication of PG strongly diminished CLinducing capacity. PG treatment with mutanolysin immediately resulted in decreased CLinducing capacity. Treatment of PG with S. aureus lytic enzyme (SALE) 10 pg/ml for up to 15 min enhanced the CL response to PMNL; a similar increase in CL was induced by PG treated with SALE at 1 pg/ml for up to 120 min. Beyond these times, a continuous decrease in PG-induced CL was observed. In conclusion, PG was found to be the major cell-wall component of S. epidermidis involved in CL induction. Moreover, a minimal fragment size or a specific tertiary structure of PG, or both, is required for metabolic activation of PMNL.

show abstract

Hospital-acquired bloodstream infections with Staphylococcus epidermidis: Review of 100 cases

Cited by 21 publications

References 0 publications

Minimizing the Workup of Blood Culture Contaminants: Implementation and Evaluation of a Laboratory-Based Algorithm

Minimizing the Workup of Blood Culture Contaminants: Implementation and Evaluation of a Laboratory-Based Algorithm

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

Chemiluminescence of human polymorphonuclear leucocytes after stimulation with whole cells and cell-wall components of Staphylococcus epidermidis

Contact Info

Product

Resources

About