Abstract
During 1984 nine of the 135 patients (pts) admitted to our NICU had 11 episodes of septi cemia with Staph epi.In the last 5 years we had 5.2±3.6 septicemias per year in pts with a central venous catheter and of those the majority i.e.3.4±3 were caused by Staph epi. Staph epi septicemia was considered to be present, when a) the newborns clinical condition deterioated, b) the blood culture was positive and c) the organism could be cultured from the catheter tip (n=7), the tracheal aspirate (6) or a skin lesion (1).Additional signs of infection included an elevated body temperature to 38±0.35° and a shift to the left in the white cell count with 11±8 bands.
The mean birth weight of our pts is 1260±700 grs; the mean gestational age 31.2±4 weeks. The mean 5 minute Apgar score was 7.9±1.5.Eight pts were ventilated for 26.9±9 days. Seven pts had a central venous catheter made of SilasticR put in for a mean 17.4±12.3 days.In 4 pts the tracheal aspirate was contaminated by Staph epi 4.8±2 days before the septicemia became clinically apparent and the organism could be cultured from the catheter tip.Six of eleven infections were associated with liver enlargment to 3 cms below the right costal margin; of those 3 had elevated liver enzymes and 3 had a mean bilirubin of 3.9±1. During the same year we had 12 pts with similar gestational age, duration of ventilation and 5 minute Apgar score, who had a central venous catheter put in during antibiotic therapy mostly for maternal infection or premature rupture of membranes. In those 12 we had 2 pts, in whom we cultured Staph epi from the catheter tip, but no pt developed clinical signs of infections or cholestasis.
Conclusions:
Staph epi has been the most frequent organism causing septicemai in our NICU.Pts with central venous lines or those, who were ventilated were at high risk of getting Staph epi septicemia, which was associated with liever enlargment.We recommend further prospective studies to clarify, wether cholestasis can be an early symptom of Staph epi septicemia.
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Vogel, M., Rocs, R., Fahrnow, I. et al. Septicemia in the Newborn Intensive Care Unit (NICU) caused by Staphylokoccus epidermidis (Staph epi). Pediatr Res 19, 1105 (1985). https://doi.org/10.1203/00006450-198510000-00213
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DOI: https://doi.org/10.1203/00006450-198510000-00213