Epidemiology and significance of coagulase-negative staphylococci isolated in blood cultures from critically ill adult patients

Savithri, Mahesh B., Iyer, Vikram, Jones, Mark, Yarwood, Trent, Looke, David, Kruger, Peter S, Faogali, Joan and Venkatesh, Bala (2011) Epidemiology and significance of coagulase-negative staphylococci isolated in blood cultures from critically ill adult patients. Critical Care and Resuscitation, 13 2: 103-107.

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Author Savithri, Mahesh B.
Iyer, Vikram
Jones, Mark
Yarwood, Trent
Looke, David
Kruger, Peter S
Faogali, Joan
Venkatesh, Bala
Title Epidemiology and significance of coagulase-negative staphylococci isolated in blood cultures from critically ill adult patients
Journal name Critical Care and Resuscitation   Check publisher's open access policy
ISSN 1441-2772
Publication date 2011-06-01
Sub-type Article (original research)
Volume 13
Issue 2
Start page 103
End page 107
Total pages 5
Place of publication Melbourne, Vic, Australia
Publisher Australasian Academy of Critical Care Medicine
Collection year 2012
Language eng
Formatted abstract
Background: Little published data are available on the epidemiology and significance of coagulase-negative staphylococci (CoNS) in blood culture isolates among critically ill adult patients.
Objectives: To describe the epidemiology and frequency of CoNS blood culture isolates in critically ill adults, and investigate the association between time to positivity (TTP) of blood cultures and number of culture-positive bottles with organ dysfunction and mortality.
Design, settings and participants: A retrospective chart audit in the intensive care unit of a tertiary hospital comprising all patients who had positive blood cultures for CoNS in 2009.
Main outcome measures:
TTP, number of culture-positive bottles, Sequential Organ Failure Assessment (SOFA) scores, resolution of fever and white cell response and inotrope requirement, length of stay in ICU and mortality.
Results: In 2009, there were 1514 and 109 positive blood culture sets for the hospital and ICU patients, respectively. Of these, 515 sets from patients outside the ICU (34% of all hospital positive blood cultures) and 54 from the ICU (49.5% of all ICU positive blood cultures) were positive for CoNS. Patients with TTP ≤24 hours had higher organ failure scores by 0.9 (95% CI, 0-3.4; P = 0.052). There was a trend towards an association between increased 28-day mortality and TTP ≤24 hours (7/22 v 3/32; P = 0.071). There was no significant correlation between number of bottles positive for culture and mortality, length of stay, SOFA score, resolution of fever, white cell response, and inotrope requirement.
Conclusions: Early TTP of blood cultures with CoNS may be associated with poorer outcome and may be a marker of true infection. Given the relatively high frequency of this microbiological problem, larger prospective observational studies are required to more clearly define the significance of a CoNS blood culture isolates in critically ill adult patients.
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Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Medicine Publications
 
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Created: Tue, 11 Oct 2011, 23:11:21 EST by Matthew Lamb on behalf of School of Medicine