title: Clinical significance of coagulase-negative staphylococci other than S. epidermidis blood stream isolates at a tertiary care hospital.
abstract: OBJECTIVE
  We retrospectively evaluated blood culture (BC) isolates of coagulase-negative staphylococci other than Staphylococcus epidermidis (NonSe-CoNS) for clinical relevance at a tertiary care hospital in Germany from January 2011 to September 2015.
  
  
  METHODS
  Clinical data were correlated to microbiological results based on medical records. Infection was considered likely if (1) no other infection and (2) two or more isolates of the same species were present and (3) symptoms ameliorated after therapy. Infection was considered possible if a foreign body was present and (1) and (3) were fulfilled. All the other cases were considered contaminations.
  
  
  RESULTS
  313 patients with blood cultures positive for NonSe-CoNS were identified. 61 patients were excluded, either because of missing data or multiple pathogens in the same blood culture. Of the remaining 252 patients, 58 (23 %) were classified as possible (n = 32) or likely (n = 26) infections. S. haemolyticus was the most frequent isolate (infection: n = 28), followed by S. hominis (n = 13), S. capitis (n = 12), and S. lugdunensis (n = 3). One patient died from NonSe-CoNS infection. The source of infection in the majority of patients was foreign bodies (n = 43), and endocarditis was present in six cases. Staphylococci always considered contaminations were: S. auricularis, S. caprae, S. schleiferi, S. pettenkoferi, S. saccharolyticus, and S. simulans. The growth of NonSe-CoNS in the anaerobic BC bottle only and a time to positivity >36 h were associated with contaminations.
  
  
  CONCLUSIONS
  One out of four NonSe-CoNS isolates was clinically relevant in our cohort, where S. haemolyticus, S. capitis, S. hominis, and S. lugdunensis contributed to 96.6 % of all relevant infections.
authors.affiliation: Stabsstelle Infektiologie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany. florian.hitzenbichler@ukr.de.|Institut für Klinische Mikrobiologie und Hygiene, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany. florian.hitzenbichler@ukr.de.
authors.forename: Florian
authors.identifier: http://orcid.org/0000-0003-4374-2787
authors.initials: F
authors.lastname: Hitzenbichler
authors.affiliation: Institut für Klinische Mikrobiologie und Hygiene, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
authors.forename: Michaela
authors.initials: M
authors.lastname: Simon
authors.affiliation: Stabsstelle Infektiologie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Salzberger
authors.affiliation: Stabsstelle Infektiologie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.|Interdisziplinäre Notaufnahme, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Hanses
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D003030:Coagulase / Q000032:analysis*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology*; D013210:Staphylococcus / Q000145:classification* / Q000302:isolation & purification*; D062606:Tertiary Care Centers; D055815:Young Adult
chemical_list: D003030:Coagulase
keywords: Bacteremia; Blood culture; Coagulase-negative Staphylococci; Contamination; S. haemolyticus; S. lugdunensis