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[Coagulase-negative staphylococcal septicemia]

F Y Huang1, C H Wang, N C Chiu

  • 1Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan, R.O.C.

Zhonghua Minguo Xiao Er Ke Yi Xue Hui Za Zhi [Journal]. Zhonghua Minguo Xiao Er Ke Yi Xue Hui
|September 1, 1994
PubMed
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Coagulase-negative Staphylococcus (CNS) causes frequent nosocomial septicemia in neonatal intensive care units. Staphylococcus hominis was the most common pathogen, with vancomycin effective against resistant strains.

Area of Science:

  • Infectious Diseases
  • Neonatal Medicine
  • Microbiology

Context:

  • Coagulase-negative Staphylococcus (CNS) is a significant cause of nosocomial septicemia, particularly in neonatal intensive care units (NICUs).
  • A retrospective study identified 41 cases of CNS septicemia between 1990 and 1992 in a pediatric department.
  • The majority of cases (85%) occurred in infants under 3 months old, with a high proportion of premature infants (47.5%) weighing less than 1,500 grams.

Purpose:

  • To investigate the incidence, causative organisms, and treatment outcomes of CNS septicemia in a pediatric setting.
  • To identify risk factors and common pathogens associated with CNS septicemia in neonates and young infants.
  • To evaluate antibiotic resistance patterns and guide therapeutic strategies for CNS infections.

Summary:

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  • Staphylococcus hominis was identified as the predominant CNS pathogen, differing from previous reports. Eighty-five percent of isolates were methicillin-resistant, and 80% of these also showed resistance to cephalosporins.
  • All CNS isolates were sensitive to vancomycin. Intravascular catheters and total parenteral nutrition were common in affected patients.
  • Treatment involved discontinuing total parenteral nutrition, obtaining blood cultures before antibiotics, and using vancomycin for methicillin-resistant cases.

Impact:

  • Highlights Staphylococcus hominis as a key pathogen in neonatal CNS septicemia, necessitating specific diagnostic and treatment approaches.
  • Emphasizes the high rates of methicillin and cephalosporin resistance, underscoring the importance of vancomycin as a treatment option.
  • Suggests that early diagnosis and prompt, appropriate antibiotic therapy, particularly vancomycin for resistant strains, lead to a generally good prognosis.