Coagulase-negative staphylococcal infections in the neonatal intensive care unit.

Published

Journal Article

BACKGROUND: Coagulase-negative staphylococci (CoNS) are the most commonly isolated pathogens in the neonatal intensive care unit (NICU). CoNS infections are associated with increased morbidity, including neurodevelopmental impairment. OBJECTIVE: To describe the epidemiology of CoNS infections in the NICU. To determine mortality among infants with definite, probable, or possible CoNS infections. METHODS: We performed a retrospective cohort study of all blood, urine, and cerebrospinal fluid cultures from samples obtained from infants aged <121 postnatal days. SETTING: A total of 248 NICUs managed by the Pediatrix Medical Group from 1997 to 2009. RESULTS: We identified 16,629 infants with 17,624 episodes of CoNS infection: 1,734 (10%) definite, 3,093 (17%) probable, and 12,797 (73%) possible infections. Infants with a lower gestational age and birth weight had a higher incidence of CoNS infection. When controlling for gestational age, birth weight, and 5-minute Apgar score, we found that infants with definite, probable, or possible CoNS infection had lower mortality (odds ratio [OR], 0.74 [95% confidence interval {CI}: 0.61, 0.89], 0.68 [95% CI, 0.59, 0.79], and 0.69 [95% CI, 0.63, 0.76], respectively) compared with infants who had negative culture results (P = .001). No significant difference in overall mortality was found in infants who had definite CoNS infection compared with those who had probable or possible CoNS infection (OR, 0.93 [95% CI, 0.75, 1.16] and 0.85 [95% CI, 0.70, 1.03], respectively). CONCLUSIONS: CoNS infection was strongly related to lower gestational age and birth weight. Infants with clinical sepsis and culture-positive CoNS infection had lower mortality rates than infants with clinical sepsis and negative blood culture results. No difference in mortality between infants with a diagnosis of definite, probable, or possible CoNS infection was observed.

Full Text

Duke Authors

Cited Authors

  • Jean-Baptiste, N; Benjamin, DK; Cohen-Wolkowiez, M; Fowler, VG; Laughon, M; Clark, RH; Smith, PB

Published Date

  • July 2011

Published In

Volume / Issue

  • 32 / 7

Start / End Page

  • 679 - 686

PubMed ID

  • 21666399

Pubmed Central ID

  • 21666399

Electronic International Standard Serial Number (EISSN)

  • 1559-6834

Digital Object Identifier (DOI)

  • 10.1086/660361

Language

  • eng

Conference Location

  • United States