Nosocomial bacteremia: Clinical significance of a single blood culture positive for coagulase-negative staphylococci

Nosocomial bacteremia: Clinical significance of a single blood culture positive for coagulase-negative staphylococci

Author Favre, B. Google Scholar
Hugonnet, S. Google Scholar
Correa, L. Google Scholar
Sax, H. Google Scholar
Rohner, P. Google Scholar
Pittet, D. Google Scholar
Institution Univ Hosp Geneva
Universidade Federal de São Paulo (UNIFESP)
Abstract OBJECTIVES: 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; CI95, 0.87-5.46) and 20.8% and 11.3%, respectively, at day 28 (PR, 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.
Language English
Date 2005-08-01
Published in Infection Control and Hospital Epidemiology. Thorofare: Slack Inc, v. 26, n. 8, p. 697-702, 2005.
ISSN 0899-823X (Sherpa/Romeo, impact factor)
Publisher Slack Inc
Extent 697-702
Origin http://dx.doi.org/10.1086/502605
Access rights Closed access
Type Article
Web of Science ID WOS:000232338800007
URI http://repositorio.unifesp.br/handle/11600/28414

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