title: Clinical Characteristics of Methicillin-resistant Coagulase-negative Staphylococcal Bacteremia in a Tertiary Hospital.
abstract: Objective Coagulase-negative staphylococci are among the most frequently isolated microorganisms in blood cultures. The aim of this study was to assess [1] the clinical characteristics of methicillin-resistant, coagulase-negative staphylococci bacteremia and [2] the susceptibility of the isolated bacteria to glycopeptides. Methods We retrospectively reviewed the medical records of 70 patients from whom methicillin-resistant coagulase-negative staphylococci had been isolated at Osaka City University Hospital between January 2010 and December 2013. We evaluated the patients' background, severity and prognosis of the disease, and the susceptibility of the isolated methicillin-resistant coagulase-negative staphylococci to glycopeptides. Results Out of the 70 patients tested, 28 (40.0%) had leukemia, and 36 (51.4%) had been treated for febrile neutropenia. Infection with Staphylococcus epidermidis accounted for 78.6% of patients. Thirty-nine cases (55.7%) were related to intravascular catheters, and 39 (55.7%) were treated using teicoplanin as a first-line therapy. The 30-day mortality rate was 4.3%. Regarding susceptibility, 20% of all isolates were non-susceptible to teicoplanin. According to multivariate analyses, it was observed that premedication using glycopeptides was independently associated with teicoplanin non-susceptibility (p=0.03; hazard ratio = 5.64; 95% confidence interval, 1.16-26.76). Conclusion Our results suggest that clinicians must use glycopeptides appropriately to prevent the development of further antibiotic resistance in methicillin-resistant coagulase-negative staphylococci.
authors.affiliation: Department of Infection Control Science, Graduate School of Medicine, Osaka City University, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Yamada
authors.forename: Hiroki
authors.initials: H
authors.lastname: Namikawa
authors.forename: Hiroki
authors.initials: H
authors.lastname: Fujimoto
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Nakaie
authors.forename: Etsuko
authors.initials: E
authors.lastname: Takizawa
authors.forename: Yasuyo
authors.initials: Y
authors.lastname: Okada
authors.forename: Akiko
authors.initials: A
authors.lastname: Fujita
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Kawaguchi
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Junko
authors.initials: J
authors.lastname: Abe
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Kaneko
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kakeya
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000188:drug therapy* / Q000382:microbiology / Q000503:physiopathology*; D003030:Coagulase; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D008297:Male; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology / Q000503:physiopathology*; D013212:Staphylococcus epidermidis / Q000302:isolation & purification; D017334:Teicoplanin / Q000627:therapeutic use; D062606:Tertiary Care Centers; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D003030:Coagulase; D017334:Teicoplanin