STAPHYLOCOCCUS EPIDERMIDIS BACTEREMIA IN NEONATES: THE OCCURRENCE OF FOCAL INFECTION

Abstract

The frequency and clinical significance of Staphylococcus epidermidis isolates from blood cultures of neonates collected over a 17 month period in The New York Hospital neonatal intensive care unit (NICU) were reviewed. Twenty-three episodes of clinically significant S. epidermidis bacteremia were identified using the criteria of isolation from 3 of 3 blood culture bottles from a single culture (6 episodes), or isolation from two or more blood cultures taken at different times (9 episodes), or simultaneous isolation from blood and fluid, pus, or vascular catheter (8 episodes). Of these 23 episodes, 10 were associated with colonized vascular catheters and four occurred in infants with necrotizing enterocolitis. Focal S. epidermidis infection occurred in 10 episodes and persistent bacteremia occurred in 7 of these episodes. S. epidermidis was the most frequent cause of bacteremia occurring in 1.2% of the neonates admitted to the NICU during the period reviewed. As assessed by disc method, 74% of the isolates determined to be clinically significant were resistant to methicillin and cephalothin and 91% were resistant to gentamicin. All isolates were sensitive to vancomycin. In addition to removing vascular catheters suspected of being colonized and searching for potential sites of focal infection, an antibiotic regimen which includes vancomycin should be initiated once clinically significant S. epidermidis bacteremia has been recognized.

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