PEDIATRICS Vol. 74 No. 5 November 1984, pp. 832-837
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Staphylococcus epidermidis Bacteremia in Neonates: Further Observations and the Occurrence of Focal Infection

Gary J. Noel MD1 and Paul J. Edelson MD1

1 From the Division of Infectious Diseases and Immunology, Department of Pediatrics, Cornell University Medical College—The New York Hospital, New York

The frequency and clinical significance of Staphylococcus epidermidis isolates from blood cultures of neonates collected during a 17-month period in The New York Hospital neonatal intensive care unit (NICU) were reviewed. Twenty-three episodes of clinically significant S epidermidis bacteremia were detected using the criteria of isolation from 3/3 blood culture bottles from a single culture, or isolation from two or more blood cultures taken at different times, or simultaneous isolation from blood and fluid, pus or vascular catheter. Of these 23 episodes of S epidermidis bacteremia, ten were associated with colonized vascular catheters, and four episodes occurred in infants with necrotizing enterocolitis. Focal S epidermidis infection occurred in ten episodes, and persistent bacteremia occurred frequently in this setting. S epidermidis was the most frequent cause of bacteremia in the Neonatal Intensive Care Unit during the period reviewed. Of the isolates determined to be clinically significant, 74% were resistant to methicillin and cephalothin and 91% were resistant to gentamicin. All isolates were sensitive to vancomycin. In addition to removing vascular catheters suspected of being colonized and searching for potential sites of focal infection, an antibiotic regimen that includes vancomycin should be initiated once significant S epidermidis bacteremia has been recognized in the neonate.

Key Words: Staphylococcus epidermidis • neonatal bacteremia • neonatal sepsis

Submitted on June 6, 1983
Accepted on January 23, 1984




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[Abstract] [Full Text]