The ConMan Trial: Coagulase Negative Staphylococcal Infections: To Treat or Not to Treat  

作　　者：David Levine Henry Spratt Caitlin Crews-Stowe Ryan Mart Jarle Stone Lani Gao Michael Davis Lindsey Brunton David Levine;Henry Spratt;Caitlin Crews-Stowe;Ryan Mart;Jarle Stone;Lani Gao;Michael Davis;Lindsey Brunton(Department of Physical Therapy, University of Tennessee at Chattanooga, Chattanooga, TN, USA;Department of Biology, Geology, and Environmental Science, University of Tennessee at Chattanooga, Chattanooga, TN, USA;Department of Health and Human Performance, University of Tennessee at Chattanooga, Chattanooga, TN, USA;Prisma Health, Greenville, SC, USA;Pennsylvania Hospital, University of Pennsylvania Health System, Philadelphia, PA, USA;Department of Mathematics, University of Tennessee at Chattanooga, Chattanooga, TN, USA;Department of Medicine, College of Medicine-Chattanooga, University of Tennessee Health Science Center, Chattanooga, TN, USA)

机构地区：[1]Department of Physical Therapy, University of Tennessee at Chattanooga, Chattanooga, TN, USA [2]Department of Biology, Geology, and Environmental Science, University of Tennessee at Chattanooga, Chattanooga, TN, USA [3]Department of Health and Human Performance, University of Tennessee at Chattanooga, Chattanooga, TN, USA [4]Prisma Health, Greenville, SC, USA [5]Pennsylvania Hospital, University of Pennsylvania Health System, Philadelphia, PA, USA [6]Department of Mathematics, University of Tennessee at Chattanooga, Chattanooga, TN, USA [7]Department of Medicine, College of Medicine-Chattanooga, University of Tennessee Health Science Center, Chattanooga, TN, USA

出　　处：《Open Journal of Blood Diseases》2024年第4期91-100,共10页血液病期刊(英文)

摘　　要：Background: Coagulase negative Staphylococci (CoNS) positive blood cultures represent a complex and common challenge in clinical medicine. CoNS are common in skin flora and are often mistaken as contamination. Conversely, CoNS can also be implicated in severe and life-threatening bacteremia requiring prompt treatment. A gray area in terms of treatment approach exists for health care providers. The primary aim of this study was to examine predictive factors in patients who have positive CoNS blood cultures that met the CDC case definition of a laboratory confirmed bloodstream infection (LCBI-II) that were subsequently found to have clinically significant true bacteremia. Methods: A retrospective cohort of 288 patients that had at least two separate blood cultures positive for a coagulase negative Staphylococci between November 1st, 2017, and November 1st, 2018, were examined to determine if there were any patient specific factors that would indicate a true bacteremia with CoNS. Results: Retrospective regression analysis demonstrated that those subjected to antibiotics for two days or more (OR = 3.01), those subjected to antibiotics for seven days or more (OR = 2.86), and patients with central access (OR = 4.06) were more likely to have a true infection. Although not statistically significant, an association was also found in immunosuppressed patients (OR = 1.65), and in patients with implanted hardware (OR = 1.16). Conclusion: Patients receiving antibiotics for greater than two days and patients with a central line were more likely to have a true bloodstream infection with coagulase negative Staphylococci.Background: Coagulase negative Staphylococci (CoNS) positive blood cultures represent a complex and common challenge in clinical medicine. CoNS are common in skin flora and are often mistaken as contamination. Conversely, CoNS can also be implicated in severe and life-threatening bacteremia requiring prompt treatment. A gray area in terms of treatment approach exists for health care providers. The primary aim of this study was to examine predictive factors in patients who have positive CoNS blood cultures that met the CDC case definition of a laboratory confirmed bloodstream infection (LCBI-II) that were subsequently found to have clinically significant true bacteremia. Methods: A retrospective cohort of 288 patients that had at least two separate blood cultures positive for a coagulase negative Staphylococci between November 1st, 2017, and November 1st, 2018, were examined to determine if there were any patient specific factors that would indicate a true bacteremia with CoNS. Results: Retrospective regression analysis demonstrated that those subjected to antibiotics for two days or more (OR = 3.01), those subjected to antibiotics for seven days or more (OR = 2.86), and patients with central access (OR = 4.06) were more likely to have a true infection. Although not statistically significant, an association was also found in immunosuppressed patients (OR = 1.65), and in patients with implanted hardware (OR = 1.16). Conclusion: Patients receiving antibiotics for greater than two days and patients with a central line were more likely to have a true bloodstream infection with coagulase negative Staphylococci.

关 键 词：Coagulase Negative Staphylococci (CoNS) Positive Blood Culture True Bacterium Central Access IMMUNOSUPPRESSED Infectious Disease 

分 类 号：R73[医药卫生—肿瘤]