title: Role of the central venous catheter in bloodstream infections caused by coagulase-negative staphylococci in very preterm neonates.
abstract: BACKGROUND
  Pathogenesis of coagulase-negative staphylococcal bloodstream infections among preterm neonates is debated: central venous catheters (CVCs) are considered the major cause and the cornerstone of prevention measures. The role of other means of transmission is unknown.
  
  
  METHODS
  We developed a specific quantitative polymerase chain reaction assay targeting the dnaJ gene from Staphylococcus epidermidis and Staphylococcus capitis to detect DNA from CVC used in preterms. Performance of the polymerase chain reaction was tested against 2 control groups of CVC yielding positive (n = 24) or negative (n = 63) conventional cultures. We also explored retrospectively the DNA load of CVC having a negative conventional bacterial culture and obtained from 34 very preterm neonates with catheter-related bloodstream infections (CR-BSIs) established by usual clinical and biologic criteria.
  
  
  RESULTS
  The molecular approach allowed detection of corresponding DNA from all the positive control catheters. Among the 34 episodes of CR-BSI yielding a negative conventional CVC culture, 8 (23.5%) had a positive polymerase chain reaction signal (5 S. epidermidis and 3 S. capitis). This percentage did not significantly differ according to the staphylococcal species, the delay between the CVC insertion and the beginning of the sepsis or between the blood culture collection and the CVC removal. These results conform to the previously published 70% of CR-BSI for whom the origin could be questioned.
  
  
  CONCLUSIONS
  CVC removal in preterms is often performed in cases of CR-BSI; our study supports the hypothesis that in some cases the responsibility of CVC is questionable.
authors: Department of Bacteriology and Infection Control, Assistance Publique - Hôpitaux de Paris, University Hospital Antoine-Béclère, Clamart, France.
authors: Margaux
authors: M
authors: Lepainteur
authors: Marine
authors: M
authors: Desroches
authors: Anne Sophie
authors: AS
authors: Bourrel
authors: Said
authors: S
authors: Aberrane
authors: Vincent
authors: V
authors: Fihman
authors: François
authors: F
authors: L'Hériteau
authors: Hasini
authors: H
authors: Razafimahefa
authors: Véronique
authors: V
authors: Derouin
authors: Florence
authors: F
authors: Doucet-Populaire
authors: Jean-Winoc
authors: JW
authors: Decousser
mesh_terms: D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology; D055499:Catheter-Related Infections / Q000453:epidemiology* / Q000382:microbiology; D062905:Central Venous Catheters / Q000382:microbiology*; D050956:HSP40 Heat-Shock Proteins / Q000235:genetics; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D015995:Prevalence; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D013210:Staphylococcus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*
chemical_list: D050956:HSP40 Heat-Shock Proteins