[Coagulase-negative staphylococcal septicemia].
In the past decade, coagulase negative Staphylococcus (CNS) has become one of the most common pathogens in nosocomial septicemia, especially in neonatal intensive care units. From January 1, 1990 to June 30, 1992, we documented 41 cases of CNS septicemia in the Department of Pediatrics at Mackay Memorial Hospital. Thirty five cases (85%) were found in infants less than 3 months of age. Nineteen patients were premature babies. Of these, 14 had a body weight less than 1,500 gms. All of the patients had intravascular catheters and 40 patients (97.5%) were receiving total parenteral nutrition. The most common causative organism isolated in this study was Staphylococcus hominis. This differs from other reports where Staphylococcus epidermidis is the most common pathogen. Eighty five percent of the organisms were resistant to methicillin and 80% of these methicillin-resistant strains were also resistant to cephalosporins. All of the organisms were sensitive to vancomycin. Because of the possibility of cross-resistance between methicillin and cephalosporin, vancomycin was chosen to treat the methicillin resistant cases. Total parenteral nutrition was discontinued before antibiotic treatment. When CNS septicemia was suspected clinically, we drew two blood cultures from different sites before beginning antibiotic therapy. This was an effort to get a definitive diagnosis. In general, the prognosis of CNS septicemia was good if early diagnosis can be made.
Huang
F Y
FY
Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan, R.O.C.
Wang
C H
CH
Chiu
N C
NC
D016470:Bacteremia / Q000209:etiology / Q000382:microbiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects; D002675:Child, Preschool; D003030:Coagulase / Q000378:metabolism; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010289:Parenteral Nutrition, Total / Q000009:adverse effects; D013203:Staphylococcal Infections / Q000209:etiology / Q000382:microbiology*; D013210:Staphylococcus / Q000201:enzymology
D003030:Coagulase