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  • Original Article
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Distinguishing true coagulase-negative Staphylococcus infections from contaminants in the neonatal intensive care unit

Journal of Perinatology volume 33, pages 52–58 (2013)Cite this article

Subjects

Abstract

Objective:

To characterize true coagulase-negative Staphylococcus (CoNS) infections in infants receiving neonatal intensive care.

Study Design:

Retrospective cohort study of neonatal intensive care unit (NICU) infants with clinical sepsis and CoNS isolated from ⩾2 blood cultures (BCs) or one BC and a sterile site (proved infection) or CoNS isolated from one BC and deemed significant after blinded data review (probable infection).

Result:

In all, 98% of 40 proved and 96% of 55 probable infections occurred in infants with birth weight (BW) <2000 g and gestation <34 weeks. Total central lines (CLs) placed, but not CL duration or presence in situ, predicted proved (odds ratio (OR) 3.5, 95% confidence interval (CI) 1.4 to 8.3; P=0.005) and probable infection (OR 2.7, 95% CI 1.3 to 5.6; P=0.007) by multivariate analysis as did lethargy and gastric residuals.

Conclusion:

True CoNS infection is unlikely in infants with BW >2000 g and gestation >34 weeks. Total CL required for care, lethargy and gastric residuals predicted true CoNS infection.

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Acknowledgements

We thank Jayne Finkowski-Rivera, MD and the physicians of Medical Center Neonatology Associates, Elena Zaccaria, MASCP, CIC, Director of Infection Control, Sally K Chabavizadeh, MASCP, MS, Department of Microbiology and the staff of the Medical Records Department, Woman's Hospital of Texas, Houston, Texas for their assistance in performing this study. We thank Marcia A Rench BSN (Baylor College of Medicine, Houston, Texas) for helpful advice on study design, data collection and analyses; E O'Brian Smith, PhD (Baylor College of Medicine) for advice on statistical analyses; and Robin Schroeder (Baylor College of Medicine) for assistance in preparing this manuscript.

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Authors and Affiliations

  1. Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA

    C M Healy, C J Baker, D L Palazzi, J R Campbell & M S Edwards

  2. Woman's Hospital of Texas, Houston, TX, USA

    C M Healy, C J Baker, D L Palazzi, J R Campbell & M S Edwards

  3. Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA

    C J Baker

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  1. C M Healy
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Correspondence to C M Healy.

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Competing interests

Dr Healy is the recipient of research grants from Sanofi Pasteur and Novartis Vaccines and Diagnostics and is on an advisory board for Novartis Vaccines and Diagnostics. Dr Palazzi has received research grants from Merck and Astellas Pharma, serves on a data safety monitoring board for Pfizer and on a speaker's bureau for Sanofi Pasteur. Dr Edwards is a consultant for Novartis Vaccines and Diagnostics.

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Healy, C., Baker, C., Palazzi, D. et al. Distinguishing true coagulase-negative Staphylococcus infections from contaminants in the neonatal intensive care unit. J Perinatol 33, 52–58 (2013). https://doi.org/10.1038/jp.2012.36

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