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Epidemiologic markers of pediatric infections caused by coagulase-negative staphylococci
W M Dunne1, D B Nelson, M J Chusid
1Department of Pediatrics, Medical College of Wisconsin, Milwaukee.
Abstract:
Several epidemiologic markers (species, slime production and antimicrobial susceptibility) were examined for 256 isolates of coagulase-negative staphylococci (C-S) obtained from clinical specimens in a 1-year period. The medical records of the 169 pediatric patients from whom the C-S were obtained were reviewed and divided into infected (N = 11) and uninfected (N = 158) groups. The phenotypic traits of strains associated with infection included: (1) slime production (P = 0.014); (2) slime-positive Staphylococcus epidermidis (P = 0.002); and (3) resistance to penicillin (P = 0.03), oxacillin (P less than 0.001), clindamycin (P = 0.003), chloramphenicol (P less than 0.001) and trimethoprim/sulfamethoxazole (P less than 0.001). Infected patients were significantly older (P = 0.006) than uninfected patients. Simultaneous isolation of the same strain of C-S from the aerobic and anaerobic bottles of a single blood culture increased the probability of sepsis (P = 0.004). The combination of these patient and laboratory data may be useful in determining the clinical significance of C-S recovered from pediatric patients.
Insights
Coagulase-negative staphylococci (C-S) infections in children are linked to slime production and antimicrobial resistance. Identifying these traits aids in determining the clinical significance of C-S in pediatric patients.
Area of Science:
- Microbiology
- Clinical Medicine
- Pediatrics
Background:
- Coagulase-negative staphylococci (C-S) are common causes of nosocomial infections.
- Understanding the factors contributing to C-S infections is crucial for effective patient management.
Purpose of the Study:
- To investigate epidemiologic markers associated with C-S infections in pediatric patients.
- To identify phenotypic traits of C-S strains that correlate with clinical infection.
Main Methods:
- Analysis of 256 C-S isolates from clinical specimens.
- Review of medical records for 169 pediatric patients, categorized into infected and uninfected groups.
- Evaluation of species, slime production, and antimicrobial susceptibility profiles.
Main Results:
- Slime production (P = 0.014) and slime-positive Staphylococcus epidermidis (P = 0.002) were significantly associated with infection.
- Infected patients were older (P = 0.006) and exhibited higher resistance to multiple antibiotics.
- Simultaneous isolation of C-S from aerobic and anaerobic blood culture bottles increased sepsis probability (P = 0.004).
Conclusions:
- Phenotypic traits like slime production and antimicrobial resistance are key indicators of C-S pathogenicity in pediatric infections.
- Patient age and specific laboratory findings, such as dual blood culture isolation, are important for assessing C-S clinical significance.
- Combining clinical and laboratory data can improve the interpretation of C-S findings in pediatric patients.