Dissemin is shutting down on January 1st, 2025

Published in

University of Toronto Press, JAMMI: Journal of the Association of Medical Microbiology and Infectious Disease, 1(2), p. 47-55, 2017

DOI: 10.3138/jammi.2.1.007

Links

Tools

Export citation

Search in Google Scholar

Central line associated bloodstream infections in the NICU: Does vancomycin-intermediate heteroresistance of coagulase-negative Staphylococcus matter?

This paper was not found in any repository, but could be made available legally by the author.
This paper was not found in any repository, but could be made available legally by the author.

Full text: Unavailable

Red circle
Preprint: archiving forbidden
Green circle
Postprint: archiving allowed
Red circle
Published version: archiving forbidden
Data provided by SHERPA/RoMEO

Abstract

Objective: To determine whether the duration of bacteremia among patients in the NICU, as well as risk of thrombocytopenia, differed between those with a central line associated bloodstream infection (CLABSI) due to a hetero-resistant vancomycin-intermediate Staphylococcus epidermidis (hVISE) and those whose CLABSI was due to vancomycin-susceptible S. epidermidis (VSSE). Methods: This retrospective cohort study covering the period from November 2009 through April 2014 examined records for 114 patients with coagulase-negative staphylococci (CoNS) CLABSI from two tertiary-care NICUs in Québec. Results: Of 111 patients included in the final analysis, 98 had an hVISE infection. The median duration of bacteremia was 4 days (range 0–33 days) for patients with hVISE and 4 days (range 2–8 days) for patients without hVISE. The duration of bacteremia was not significantly different between those with and without hVISE infection (B=−0.56, 95% CI −2.76 to 1.65). Further, the risk of thrombocytopenia for patients with and without hVISE was not significantly different (OR 0.42, 95% CI 0.076 to 2.72). Conclusions: hVISE was not shown to be associated with a longer duration of bacteremia or a greater risk of thrombocytopenia. This suggests that hVISE may not have a greater clinical impact than VSSE in infants with CLABSI. However, due to the small number of patients with VSSE in our cohort, firm conclusions cannot be drawn. Larger, multi-centre studies are needed to assess the true clinical relevance of vancomycin-intermediate hetero-resistant coagulase-negative staphylococci (hVICoNS) and before concluding on the need for hV identification in a clinical laboratory.