Journal of perinatology : official journal of the California Perinatal Association · 2012
Distinguishing true coagulase-negative Staphylococcus infections from contaminants in the neonatal intensive care unit.
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Healy C M, Baker C J, Palazzi D L, Campbell J R, Edwards M S
Аннотация
OBJECTIVE: To characterize true coagulase-negative Staphylococcus (CoNS) infections in infants receiving neonatal intensive care.
STUDY DESIGN: Retrospective cohort study of neonatal intensive care unit (NICU) infants with clinical sepsis and CoNS isolated from ≥ 2 blood cultures (BCs) or one BC and a sterile site (proved infection) or CoNS isolated from one BC and deemed significant after blinded data review (probable infection).
RESULT: In all, 98% of 40 proved and 96% of 55 probable infections occurred in infants with birth weight (BW) <2000 g and gestation <34 weeks. Total central lines (CLs) placed, but not CL duration or presence in situ, predicted proved (odds ratio (OR) 3.5, 95% confidence interval (CI) 1.4 to 8.3; P=0.005) and probable infection (OR 2.7, 95% CI 1.3 to 5.6; P=0.007) by multivariate analysis as did lethargy and gastric residuals.
CONCLUSION: True CoNS infection is unlikely in infants with BW >2000 g and gestation >34 weeks. Total CL required for care, lethargy and gastric residuals predicted true CoNS infection.
STUDY DESIGN: Retrospective cohort study of neonatal intensive care unit (NICU) infants with clinical sepsis and CoNS isolated from ≥ 2 blood cultures (BCs) or one BC and a sterile site (proved infection) or CoNS isolated from one BC and deemed significant after blinded data review (probable infection).
RESULT: In all, 98% of 40 proved and 96% of 55 probable infections occurred in infants with birth weight (BW) <2000 g and gestation <34 weeks. Total central lines (CLs) placed, but not CL duration or presence in situ, predicted proved (odds ratio (OR) 3.5, 95% confidence interval (CI) 1.4 to 8.3; P=0.005) and probable infection (OR 2.7, 95% CI 1.3 to 5.6; P=0.007) by multivariate analysis as did lethargy and gastric residuals.
CONCLUSION: True CoNS infection is unlikely in infants with BW >2000 g and gestation >34 weeks. Total CL required for care, lethargy and gastric residuals predicted true CoNS infection.
Предметные рубрики MeSH
BacteremiaCatheterization, Central VenousCoagulaseCross InfectionCross-Sectional StudiesCulture MediaDiagnosis, DifferentialEquipment ContaminationFemaleHumansInfant, Extremely Low Birth WeightInfant, Low Birth WeightInfant, NewbornIntensive Care Units, NeonatalMaleRecurrenceRetrospective StudiesRisk FactorsStaphylococcal InfectionsStaphylococcus