title: Distinguishing true coagulase-negative Staphylococcus infections from contaminants in the neonatal intensive care unit.
abstract: OBJECTIVE
  To characterize true coagulase-negative Staphylococcus (CoNS) infections in infants receiving neonatal intensive care.
  
  
  METHODS
  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).
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA. chealy@bcm.edu
authors.forename: C M
authors.initials: CM
authors.lastname: Healy
authors.forename: C J
authors.initials: CJ
authors.lastname: Baker
authors.forename: D L
authors.initials: DL
authors.lastname: Palazzi
authors.forename: J R
authors.initials: JR
authors.lastname: Campbell
authors.forename: M S
authors.initials: MS
authors.lastname: Edwards
mesh_terms: D016470:Bacteremia / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology*; D002405:Catheterization, Central Venous; D003030:Coagulase / Q000378:metabolism*; D003428:Cross Infection / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology*; D003430:Cross-Sectional Studies; D003470:Culture Media; D003937:Diagnosis, Differential; D004866:Equipment Contamination; D005260:Female; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology*; D013210:Staphylococcus / Q000201:enzymology*
chemical_list: D003030:Coagulase; D003470:Culture Media