Article Text

Download PDFPDF
A ten year, multicentre study of coagulase negative staphylococcal infections in Australasian neonatal units
  1. D Isaacs,
  2. On Behalf Of The Australasian Study Group For Neonatal Infections
  1. Department of Immunology and Infectious Diseases, Children's Hospital Westmead, Westmead, NSW 2145, Australia
  1. Correspondence to:
    Clinical Professor Isaacs, Department of Immunology and Infectious Diseases, Children's Hospital Westmead, Locked Bag 4001, Westmead, NSW 2145, Australia;
    davidi{at}chw.edu.au

Abstract

Objective: To study late onset systemic infections with coagulase negative staphylococci.

Methods: Prospective longitudinal study of coagulase negative staphylococcal infection in 18 Australasian neonatal nurseries.

Results: From 1991 to 2000 inclusive, there were 1281 cases of coagulase negative staphylococcal (CoNS) sepsis, comprising 57.1% of all late onset infections. The male/female ratio was 1.27:1 (p < 0.05). The incidence of CoNS sepsis was 3.46 episodes per 1000 live births. Most infected babies (71%) were 24–29 weeks gestation at birth (mode 26 weeks). The first positive culture was day 7–14 in 49% of babies (mode 10 days). Five cases of meningitis were reported, an incidence of 0.4% of all CoNS infections. Twenty nine babies (2.3%) had concurrent necrotising enterocolitis and CoNS septicaemia. Four babies (0.3%) died from CoNS infection, but CoNS infection possibly contributed to the death of an additional 20 babies (1.6%). The mortality directly attributable to CoNS infection was significantly lower than that from late onset infections with Staphylococcus aureus (13.1%; relative risk (RR) = 36.1 (95% confidence interval (CI) 13.0 to 100.2) or with Gram negative bacilli (14.2%; RR = 45.5 (95% CI 16.8 to 123.3)).

Conclusions: CoNS are currently responsible for most late onset neonatal infections. Most infected babies are < 30 weeks gestation at birth, and usually present between 7 and 14 days of age. CoNS infections may be associated with necrotising enterocolitis, although causality is unproven. Neonatal CoNS infections are relatively benign: meningitis is rare and mortality low compared with infection from other organisms. Over-vigorous attempts to reduce the incidence of CoNS infections using prophylactic antibiotics are not advisable.

  • Staphylococcus epidermidis
  • nosocomial infections
  • late onset
  • necrotising enterocolitis
  • meningitis
  • CoNS, coagulase negative staphylococci
  • CSF, cerebrospinal fluid
  • NEC, necrotising enterocolitis

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.