Coagulase-negative staphylococcal bacteremia in newborns

Area of Science:

• Neonatal Intensive Care Unit (NICU) infections
• Pediatric infectious diseases
• Clinical microbiology

Background:

• Coagulase-negative staphylococci (C-NS) are increasingly recognized as pathogens in neonatal sepsis.
• Distinguishing true C-NS bacteremia from contamination is critical for appropriate patient management.

Purpose of the Study:

• To review the incidence and clinical significance of C-NS blood culture isolates in infants with suspected septicemia.
• To evaluate methods for differentiating C-NS bacteremia from contamination in a neonatal intensive care unit (NICU) population.

Main Methods:

• Retrospective review of C-NS blood culture isolates from infants with suspected septicemia over an 18-month period.
• Analysis of culture results, patient demographics, and clinical outcomes to assess bacteremia versus contamination.

Main Results:

• 2.2% of blood cultures yielded C-NS.
• Of 30 infants, 20% had bacteremia, 57% probable contaminants, and 23% indeterminate results.
• Contaminants were more frequent in the first week of life; bacteremia onset occurred later.

Conclusions:

• C-NS blood culture growth in neonates can represent nosocomial bacteremia but is often contamination, particularly in the first week of life.
• Obtaining at least two paired peripheral blood cultures is recommended to differentiate true bacteremia from contamination in infants with suspected septicemia.