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[Non-epidermidis coagulase-negative staphylococci in infectious diseases of the compromised host]
A Fabbri1, A Tacchella, V Mondino
1II Clinica Malattie Infettive, Università di Genova, Italia.
Abstract:
Today Staphylococcus epidermidis has been recognized as the etiological agent of infectious diseases such as endocarditis, sepsis and meningitis that mainly come out in compromised hosts because of the breaching of the mechanical barrier (cardiosurgical, neurosurgical patients and central venous catheter carriers). Other "non-epidermidis coagulase negative Staphylococci" are more and more frequently isolated from patients at high risk of infection. Faced with these isolations, it is difficult for the clinician and the microbiologist to give these microorganisms their effective pathogenic role. The Authors present a case list of seriously compromised patients in whom non-epidermidis coagulase negative Staphylococci were repeatedly isolated: hemato-oncological patients: the Authors mark out 6 cases of sepsis that is, likely, to be linked to a central venous catheter. The isolated microorganisms were: S. warneri (3 cases); S. haemolyticus (1 case); S. hominis (1 case); S. xylosus (1 case); neurosurgical patients: in whom 3 cases of cerebro-spinal fluid infection were observed; 3 patients carried a ventriculo-peritoneal derivation; 1 patient carried an Ommaya's device. The etiological agents were S. haemolyticus in 2 cases, S. capitis in 1 case. The Authors point out the multiresistance of some strains (S. haemolyticus) and the oxacillin-methicillin resistance phenomenon. They also underline the need for a specific identification of coagulase-negative Staphylococci and the importance of a strict collaboration between clinicians and microbiologists in order to get a correct interpretation of the role played by these microorganisms in infectious diseases of the compromised host.
Insights
Non-epidermidis coagulase-negative Staphylococci are increasingly isolated from high-risk patients. Accurate identification and clinical collaboration are crucial for understanding their pathogenic role in infections.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Clinical Pathology
Background:
- Staphylococcus epidermidis is a known cause of infections in compromised hosts.
- Non-epidermidis coagulase-negative Staphylococci (CoNS) are frequently isolated from high-risk patients.
- Distinguishing the pathogenic role of non-epidermidis CoNS is challenging for clinicians and microbiologists.
Purpose of the Study:
- To investigate the pathogenic role of non-epidermidis CoNS in severely compromised patients.
- To report cases of sepsis and central nervous system infections linked to non-epidermidis CoNS.
- To highlight antimicrobial resistance patterns and the importance of accurate identification.
Main Methods:
- Retrospective case series analysis.
- Isolation and identification of Staphylococci species from blood and cerebrospinal fluid.
- Review of patient clinical data and outcomes.
Main Results:
- Six cases of sepsis likely associated with central venous catheters in hemato-oncological patients involved S. warneri, S. haemolyticus, S. hominis, and S. xylosus.
- Three cases of cerebrospinal fluid infections in neurosurgical patients involved S. haemolyticus and S. capitis.
- Multidrug resistance, including oxacillin-methicillin resistance, was observed in some strains, particularly S. haemolyticus.
Conclusions:
- Non-epidermidis CoNS can be significant pathogens in immunocompromised individuals.
- Accurate species-level identification of CoNS is essential for appropriate patient management.
- Close collaboration between clinicians and microbiologists is vital for interpreting the significance of CoNS isolates.