Bloodstream infections caused by small-colony variants of coagulase-negative staphylococci following pacemaker

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C von Eiff1, P Vaudaux, B C Kahl

  • 1Institute of Medical Microbiology, University of Münster, Germany. eiffc@uni-muenster.de

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|December 10, 1999
PubMed

Insights

Small-colony variants (SCVs) of coagulase-negative staphylococci can cause persistent pacemaker infections. These slow-growing Staphylococcus epidermidis and Staphylococcus capitis SCVs require specific detection methods to avoid missed diagnoses.

Area of Science:

  • Microbiology
  • Infectious Diseases

Background:

  • Small-colony variants (SCVs) of Staphylococcus aureus are known to cause persistent infections.
  • Infections caused by SCVs of coagulase-negative staphylococci (CoNS) are less understood.

Observation:

  • Two cases of pacemaker electrode infections caused by SCVs of Staphylococcus epidermidis and Staphylococcus capitis are presented.
  • Isolates exhibited distinct colony morphologies but were confirmed as clonal using pulsed-field gel electrophoresis.
  • All identified SCVs demonstrated hemin dependency.

Findings:

  • SCVs of S. epidermidis and S. capitis can cause challenging pacemaker-related infections.
  • Despite morphological differences, isolates from sequential blood cultures were genetically identical.
  • Hemin auxotrophism was a common characteristic of the observed SCVs.

Implications:

  • Clinicians should actively search for CoNS SCVs in persistent infections, as their slow growth can lead to missed diagnoses.
  • Understanding the characteristics of CoNS SCVs is crucial for effective treatment and management of device-related infections.
  • These findings highlight the importance of considering SCVs in the differential diagnosis of device-associated staphylococcal infections.

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