1 St Jude Children's Research Hospital, Memphis, Tennessee
In Reply.
The first issue raised by Drs Noel and Edelson is that of the reported in vitro heteroresistance of coagulase-negative staphylococci.1 They suggest that this phenomenon could have been expressed by some of the isolates infecting our patients and explain the persistent bacteremia. Although such speculation should be investigated, there are no published studies proving or refuting its validity. Heteroresistance among strains of Staphylococcus aureus has been analyzed with respect to clinical outcome, and no persistent infections were observed.2