PEDIATRICS Vol. 84 No. 6 December 1989, pp. 977-985
This Article
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Patrick, C. C.
Right arrow Articles by Mason, E. O.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Patrick, C. C.
Right arrow Articles by Mason, E. O., Jr

Persistent Bacteremia Due to Coagulase-Negative Staphylococci in Low Birth Weight Neonates

Christian C. Patrick MD, PhD1, Sheldon L. Kaplan MD1, Carol J. Baker MD1, Joseph T. Parisi PhD1, and Edward O. Mason Jr PhD1

1 The Myers-Black Section of Infectious Diseases, the Department of Pediatrics, and Microbiology and Immunology, Baylor College of Medicine, Houston, Texas, and the Department of Microbiology, School of Medicine, University of Missouri-Columbia, Columbia

During a 6-month period in 1987, 13 low birth weight neonates without indwelling central intravascular catheters had persistent (positive blood cultures for ge6 days) coagulase-negative staphylococcal bacteremia despite adequate antibiotic therapy. Daily blood cultures remained persistently positive for a mean of 13 days (range 6 to 25 days). This group of infants was compared with other low birth weight infants with similar birth weights and nonpersistent coagulase-negative staphylococcal bacteremia, defined as two or more positive blood cultures accompanied by supporting clinical manifestations of sepsis. During this period, coagulase-negative staphylococcal represented 29% of all bacteremias, and 33% of coagulase-negative staphylococcal bacteremias were persistent. Other than soft tissue abscesses, none of the infants with persistent coagulase-negative staphylococcal bacteremia had a defined focus of infection. Abdominal distention (P= .001) and thrombocytopenia (P<.03) occurred significantly more frequently in the patients with persistent coagulase-negative staphylococcal bacteremia than in those with nonpersistent bacteremia. Of the 13 patients with persistent coagulase-negative staphylococcal bacteremia, 2 received methicillin and 11 received vancomycin. No antibiotic tolerance to either antibiotic could be demonstrated. Serum concentrations of vancomycin far exceeded the minimum bactericidal concentration in all cases in which vancomycin was prescribed. No in vitro differences could be demonstrated between persistent and nonpersistent coagulase-negative staphylococcal strains for slime production, biotype, proteins from modified whole cell lysates developed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and opsonophagocytosis by adult neutrophils in the presence of pooled human sera. Additionally, plasmid profile analysis and phage typing revealed no common strain causing the persistent bacteremia. The pathogenesis of persistent coagulase-negative staphylococcal bacteremia in low birth weight neonates without intravascular catheters remains obscure.

Key Words: coagulase-negative staphylococcal bacteremia • low birth weight neonate

Submitted on October 11, 1988
Accepted on February 2, 1989




This article has been cited by other articles:


Home page
 PediatricsHome page
M. Khashu, H. Osiovich, D. Henry, A. A. Khotani, A. Solimano, and D. P. Speert
Persistent Bacteremia and Severe Thrombocytopenia Caused by Coagulase-Negative Staphylococcus in a Neonatal Intensive Care Unit
Pediatrics, February 1, 2006; 117(2): 340 - 348.
[Abstract] [Full Text] [PDF]

Home page
 Antimicrob. Agents Chemother.Home page
E. V. Capparelli, B. T. Bloom, T. J. Kueser, D. G. Oelberg, E. M. Bifano, R. D. White, R. L. Schelonka, S. A. Pearlman, J. Patti, and S. V. Hetherington
Multicenter Study To Determine Antibody Concentrations and Assess the Safety of Administration of INH-A21, a Donor-Selected Human Staphylococcal Immune Globulin, in Low-Birth-Weight Infants
Antimicrob. Agents Chemother., October 1, 2005; 49(10): 4121 - 4127.
[Abstract] [Full Text] [PDF]

Home page
 J. Clin. Microbiol.Home page
K. J. Center, A. C. Reboli, R. Hubler, G. L. Rodgers, and S. S. Long
Decreased Vancomycin Susceptibility of Coagulase-Negative Staphylococci in a Neonatal Intensive Care Unit: Evidence of Spread of Staphylococcus warneri
J. Clin. Microbiol., October 1, 2003; 41(10): 4660 - 4665.
[Abstract] [Full Text] [PDF]