Coagulase Negative Staphylococci in the Neonatal Intensive Care Unit: Are We Any Smarter?

Nash, Colleen B.; Chu, Alison; Bhatti, Micah M.; Alexander, Kenneth A.; Schreiber, Michael D.; Hageman, Joseph R.

doi:10.1542/neo.14-6-e284

Cited by 7 publications

(6 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We also observed that the prevalence of Gram-positive organisms in NICU was high (1.67% of total isolates, 48% of NICU isolates, n = 756) that could be attributed to the high frequency of prematurity and very low birth weight in the neonatal population which is the most important host risk factors for coagulase-negative staphylococci (CoNS) infection. The greater number of skin breaks for catheter insertion was also considered as a significant predictor of CoNS sepsis as well as total parenteral nutrition (TPN) use with or without a central venous catheter has been demonstrated to be a risk factor [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Antibiograms of intensive care units at an Egyptian tertiary care hospital

et al. 2021

View full text Add to dashboard Cite

Background Intensive care unit (ICU) infection management is a growing challenge, and physicians should have regularly updated antibiograms. The aim of this study was to find out the prevalence of pathogens and to determine their antibiotic susceptibility in different ICUs of an Egyptian tertiary care hospital. This retrospective record-based cross-sectional study was conducted from the first of January to the last of December 2019 with a total of 45,221 diagnostic first-isolate culture/patient obtained from different ICUs in Zagazig University Hospitals. The antibiogram construction was done according to Clinical and Laboratory Standards Institute instructions and a Web-based antibiogram at Stanford University. Results The positive blood isolate was the most prevalent infection site (32.37%) followed by sputum and urine isolates. Gram-negative microorganisms (74.41%) were the most common pathogens, with Klebsiella pneumoniae as the most frequently identified one with an incidence of 33.51% followed by Escherichia coli with 19.3% incidence. Antibiotic sensitivity showed that colistin is the most effective antibiotic with 96.2%, 94.7%, and 89.9% sensitivity for Klebsiella, E. coli, and Acinetobacter, respectively, while carbepenems sensitivity was extremely low, showing 19.5% and 19% imipenem and meropenem sensitivity for Klebsiella, 48% imipenem and 52.7% meropenem sensitivity for E. coli, 20.1% imipenem and 20.3% meropenem sensitivity for Acinetobacter, and 17.3% imipenem and 15.2% meropenem sensitivity for Pseudomonas aeruginosa. Fungal infection in our results represented less than 1%. Conclusion Our study provides a local baseline epidemiological data which describes the extent of the ICU infections problem in this tertiary care hospital. Trial registration ClinicalTrials.gov (NCT04318613)

show abstract

Section: Discussionmentioning

confidence: 99%

Antibiograms of intensive care units at an Egyptian tertiary care hospital

et al. 2021

View full text Add to dashboard Cite

show abstract

“…18 In spite of microbiological advances, there are no consensus on definitions and practices with CoNS infection among the clinicians thus resulting in over presentation of CoNS as true pathogen. 3 Further multicentric large sample size, case control studies are needed to develop clinical predictability scoring to identify CoNS true infection so that it can be treated wisely and cost effectively which can reduce the exciting dilemma.…”

Section: Discussionmentioning

confidence: 99%

“…Coagulase negative Staphylococcus aureus (CoNS) is one of the important organisms encountered during evaluation of clinical sepsis in a neonate. 3 On one hand, there is increased survival of low birth weight (LBW) and preterm babies needing invasive procedures which predisposes to CoNS infections; on the other hand vague clinical symptoms of this low virulent organisms with difficulties to differentiate contaminants from true bacteremia in blood culture, coupled with no clear laboratory confirmative evidence of sepsis makes the clinician less confident to withhold reserve antibiotics like vancomycin from sick babies at NICU.…”

Section: Introductionmentioning

confidence: 99%

Blood contamination in neonates: clinicians' dilemma

Iyer

Naveen

et al. 2015

Int J Contemp Pediatr

View full text Add to dashboard Cite

“…6) The finding that coagulase-negative staphylococcus (CONS) was the commonest organism in both early-and late-onset sepsis should be viewed with caution in light of the great controversy about the criteria for defining CONS sepsis in newborns (6). These criteria have often resulted in CONS being overrepresented as a true pathogen in neonatal sepsis (7).…”

Section: Dear Editormentioning

confidence: 99%

Letter to the Editor: Prevalence and Antibiotic Resistance of Neonatal Sepsis Pathogens

Mandal

Sahi

2016

Arch Pediatr Infect Dis

View full text Add to dashboard Cite

We read with great interest the original article by Behmadi et al. (1) in the most recent issue of your journal. We would like to commend the authors for their endeavor but at the same time feel that few necessary clarifications and comments would benefit the general readers of the journal:1) The abstract mentions that "the aim of this study was to determine the prevalence and evaluate the antimicrobial susceptibility patterns of bacterial infections at a neonatal unit," but the main text states that the objective was "to determine the frequency and antibiotic resistance of pathogens at the neonatal intensive-care unit (NICU) and neonatal ward of our hospital." The study, being "crosssectional" in design, is able to give prevalence but not frequency or incidence (2). Furthermore, the pathogens associated with neonatal sepsis include viruses and parasites, in addition to bacteria (3).2) The authors mention the total number of culture (blood, urine and cerebrospinal fluid (CSF)) samples and their positivity rates, but not the total number of newborns being assessed (sample size). Therefore, the percentage of newborns who ultimately have culture (blood, urine or CSF)-positive sepsis indicative of prevalence of bacterial infection, which is one of the study's primary objectives, can never be ascertained.3) The authors do not provide a definition for terms such as "late-onset sepsis" and "clinical findings suggesting urinary tract infection (UTI)." Different epidemiological studies have used cut-offs ranging from 3 to 7 days to define late-onset sepsis, depending on the gestational age and birth weight of the newborn (4). Also, there are no clinical findings that specifically suggest UTI in a newborn.4) The methodology does not state how the urine sample for bacterial culture was collected. It should ideally be collected by suprapubic aspiration (5); other methods are associated with high chances of contamination.5) The authors also do not mention whether hospitalacquired infections were included in the late-onset sepsis group. The causative organisms and the antibiotic sensitivity pattern are expected to vary considerably depending on whether the source of infection is the community or a heath care facility (5). Hospital-acquired pathogens could also explain the high prevalence of antibiotic resistance in the isolated organisms.6) The finding that coagulase-negative staphylococcus (CONS) was the commonest organism in both early-and late-onset sepsis should be viewed with caution in light of the great controversy about the criteria for defining CONS sepsis in newborns (6). These criteria have often resulted in CONS being overrepresented as a true pathogen in neonatal sepsis (7). In an attempt to decrease falsepositivity rates, various investigators have proposed different diagnostic algorithms based upon quantitative culture and colony count, presence of an indwelling central venous catheter (8) or time to positivity of blood culture (9).

show abstract

Coagulase Negative Staphylococci in the Neonatal Intensive Care Unit: Are We Any Smarter?

Cited by 7 publications

References 50 publications

Antibiograms of intensive care units at an Egyptian tertiary care hospital

Antibiograms of intensive care units at an Egyptian tertiary care hospital

Blood contamination in neonates: clinicians' dilemma

Letter to the Editor: Prevalence and Antibiotic Resistance of Neonatal Sepsis Pathogens

Contact Info

Product

Resources

About