PEDIATRICS Vol. 82 No. 2 August 1988, pp. 234-239
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Neonatal Staphylococcus epidermidis Right-Sided Endocarditis: Description of Five Catheterized Infants

Gary J. Noel MD1, John E. O'Loughlin MD1, and Paul J. Edelson MD1

1 From the Department of Pediatrics, Divisions of Pediatric Infectious Diseases and Immunology, and Pediatric Cardiology, New York Hospital-Cornell University Medical Center, New York

Coagulase-negative staphylococci are important causes of bacteremia and focal infections in infants hospitalized in neonatal intensive care units. The medical records and echocardiograms of 58 newborns with persistent Staphylococcus epidermidis bacteremia who were hospitalized in the neonatal intensive care unit at The New York Hospital during the past 5frac12 years were reviewed, and five infants were identified as having S epidermidis right-sided infective endocarditis. These episodes were associated with placement of umbilical venous catheters in the right atrium, slow resolution of bacteremia, and persistent thrombocytopenia. This experience suggests the role of endocardial trauma resulting from the placement of umbilical venous catheters in the pathogenesis of endocarditis. The increasing importance of coagulase-negative staphylococci as a cause of bacteremia in the newborn may explain the emergence of S epidermidis as an important cause of infective endocarditis in the neonatal intensive care unit. These cases underscore the potential severity of S epidermidis infection in the premature newborn.

Key Words: Staphylococcus epidermis • endocarditis • neonate

Submitted on October 23, 1987
Accepted on January 8, 1988




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