title: Clinical significance of coagulase-negative staphylococci isolates from nosocomial bloodstream infections.
abstract: BACKGROUND
  Identification of coagulase-negative staphylococci (CoNS) as nosocomial pathogens or contaminants is significant for microbiologists and clinicians. This study aimed to determine the frequency of isolation and antimicrobial resistance patterns of CoNS isolates from nosocomial bloodstream infections (BSIs) and to identify risk factors associated with true bacteremia caused by these emerging pathogens in a Saudi tertiary care hospital.
  
  
  METHODS
  All CoNS-positive cultures from inpatients were identified using the standard methods during a 10-month period. Antimicrobial susceptibility testing was done using the reference broth microdilution method.
  
  
  RESULTS
  A total of 208 isolates were identified; of these 75 (32.2%) were considered infection associated, and 133 (67.8%) were considered contamination. S. epidermidis accounted for 34.7% of bacteremia cases, followed by S. hominis (21.3%), S. haemolyticus (16%), and S. saprophyticus (12%). Central venous catheters (p ≤ 0.0001), prior antibiotic therapy (p ≤ 0.0001), the occurrence of more than one positive blood culture (p ≤ 0.0001), and intensive care unit (ICU) admission (p = 0.007) were all independently associated with CoNS bacteremia. Overall, all isolates were highly resistant to penicillin (94.7%), oxacillin (90.7%), and erythromycin (85.3%). The rates of susceptibility to vancomycin, daptomycin, and teicoplanin were 98.7%, 98.7%, and 93.3%, respectively.
  
  
  CONCLUSIONS
  Our results further highlight that accurate identification and susceptibility testing of CoNS isolates from nosocomial BSIs are crucial to minimize excessive antibiotic use and unnecessary catheter removal. In addition, daptomycin may be an efficient alternative therapeutic option for CoNS resistant to oxacillin and other commonly used antibiotics.
authors.affiliation: a Department of Microbiology, College of Medicine , Najran University , Najran ;
authors.forename: Ahmed Morad
authors.initials: AM
authors.lastname: Asaad
authors.affiliation: b Department of Microbiology, College of Medicine , Najran University , Najran ;
authors.forename: Mohamed
authors.initials: M
authors.lastname: Ansar Qureshi
authors.affiliation: c Laboratories Department , King Khalid Hospital , Najran , Saudi Arabia.
authors.forename: Syed
authors.initials: S
authors.lastname: Mujeeb Hasan
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D003030:Coagulase; D003428:Cross Infection / Q000382:microbiology*; D003430:Cross-Sectional Studies; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012529:Saudi Arabia; D013203:Staphylococcal Infections / Q000382:microbiology*; D013210:Staphylococcus / Q000187:drug effects* / Q000201:enzymology
chemical_list: D000900:Anti-Bacterial Agents; D003030:Coagulase
keywords: Coagulase-negative staphylococci; antimicrobial resistance; bacteremia; daptomycin; oxacillin