title: Persistent coagulase-negative staphylococci bacteremia in very-low-birth-weight infants.
abstract: This study sought to expand current knowledge on the clinical and epidemiological characteristics of persistent coagulase-negative Staphylococcus (CoNS) bacteremia in very-low-birth-weight (VLBW) infants. Background and disease-related data were collected prospectively on 143 VLBW infants diagnosed with CoNS bacteremia at a pediatric tertiary medical center in 1995-2003. Findings were compared between those with persistent (positive blood cultures for >72 h under appropriate treatment ) and nonpersistent disease. Fifty-eight infants (40.6%) were found to have persistent bacteremia. There were no between-group differences in maternal characteristics, mode of delivery, newborn characteristics, dwell time of central venous and umbilical catheters, complications of prematurity, or mean hospital stay. The persistent bacteremia group had significantly higher rates of hypothermia at presentation (37.9% vs. 17.6%, p < 0.04), creatinine >1.2 mg% on treatment day 7 (13.7% vs. 2.4%, p < 0.02; transient phenomenon), and endocarditis (p < 0.03); one infant had an aortic thrombus. Predominantly breast-fed infants had a higher rate of negative cultures within 72 h of appropriate treatment than predominantly formula-fed infants (60% vs. 19%, p < 0.02). In conclusion, persistence of CoNS bacteremia is common in VLBW infants. Endocarditis should be excluded in all infants with persistent disease. Breast-feeding is associated with a shorter disease duration.
authors.affiliation: Department of Neonatology, Rabin Medical Center, 2 Denmark St, Petach Tikva, 49100, Israel. linderm@netvision.net.il
authors.forename: Nehama
authors.initials: N
authors.lastname: Linder
authors.forename: Adriana
authors.initials: A
authors.lastname: Hernandez
authors.forename: Limor
authors.initials: L
authors.lastname: Amit
authors.forename: Gil
authors.initials: G
authors.lastname: Klinger
authors.forename: Shai
authors.initials: S
authors.lastname: Ashkenazi
authors.forename: Itzhak
authors.initials: I
authors.lastname: Levy
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D001942:Breast Feeding; D003030:Coagulase / Q000378:metabolism; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D013210:Staphylococcus / Q000201:enzymology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D003030:Coagulase