1 Department of Pediatrics, Baylor College of Medicine, Houston, Texas
Colonization of neonates with coagulase-negative staphylococci occurs predictably during the first weeks of life, serving as a potential source of bacteremia in very low birth weight infants.1,2 Clinical features alone are insufficient to distinguish sepsis caused by neonatal pathogens other than coagulase-negative staphylococci3 or to differentiate sepsis from noninfectious disorders in these tiny patients. Inasmuch as coagulase-negative staphylococci are the most frequent blood culture isolates from patients in most neonatal intensive care units4,5 and are a cause of substantial morbidity,6 the statement of Freeman et al7 that "blood cultures positive for coagulase-negative staphylococci are almost four times as likely to be perceived as clinically significant if obtained from extremely premature infants" is not surprising.