Clinical Characteristics of Methicillin-resistant Coagulase-negative Staphylococcal Bacteremia in a Tertiary Hospital

• Published in: Internal Medicine Vol. 56; no. 7; pp. 781 - 785
• Main Authors: Yamada, Koichi, Namikawa, Hiroki, Fujimoto, Hiroki, Nakaie, Kiyotaka, Takizawa, Etsuko, Okada, Yasuyo, Fujita, Akiko, Kawaguchi, Hiroyoshi, Nakamura, Yasutaka, Abe, Junko, Kaneko, Yukihiro, Kakeya, Hiroshi
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01-01-2017; Japan Science and Technology Agency
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents - therapeutic use; Antibiotic resistance; Antibiotics; Bacteremia; Bacteremia - drug therapy; Bacteremia - microbiology; Bacteremia - physiopathology; catheter-related bloodstream infection; Catheters; Coagulase; Drug resistance; Drug Resistance, Bacterial; Female; Glycopeptides; Humans; Internal medicine; Leukemia; Male; Medical records; Methicillin; Methicillin Resistance; methicillin-resistant coagulase-negative staphylococci; Microbial Sensitivity Tests; Microorganisms; Middle Aged; Neutropenia; Original; Prognosis; Retrospective Studies; Severity of Illness Index; Staphylococcal Infections - drug therapy; Staphylococcal Infections - microbiology; Staphylococcal Infections - physiopathology; Staphylococcus epidermidis - isolation & purification; Teicoplanin; Teicoplanin - therapeutic use; teicoplanin non-susceptibility; Tertiary Care Centers; Young Adult
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.56.7715

Objective Coagulase-negative staphylococci are among the most frequently isolated microorganisms in blood cultures. The aim of this study was to assess [1] the clinical characteristics of methicillin-resistant, coagulase-negative staphylococci bacteremia and [2] the susceptibility of the isolated bacteria to glycopeptides. Methods We retrospectively reviewed the medical records of 70 patients from whom methicillin-resistant coagulase-negative staphylococci had been isolated at Osaka City University Hospital between January 2010 and December 2013. We evaluated the patients' background, severity and prognosis of the disease, and the susceptibility of the isolated methicillin-resistant coagulase-negative staphylococci to glycopeptides. Results Out of the 70 patients tested, 28 (40.0%) had leukemia, and 36 (51.4%) had been treated for febrile neutropenia. Infection with Staphylococcus epidermidis accounted for 78.6% of patients. Thirty-nine cases (55.7%) were related to intravascular catheters, and 39 (55.7%) were treated using teicoplanin as a first-line therapy. The 30-day mortality rate was 4.3%. Regarding susceptibility, 20% of all isolates were non-susceptible to teicoplanin. According to multivariate analyses, it was observed that premedication using glycopeptides was independently associated with teicoplanin non-susceptibility (p=0.03; hazard ratio = 5.64; 95% confidence interval, 1.16-26.76). Conclusion Our results suggest that clinicians must use glycopeptides appropriately to prevent the development of further antibiotic resistance in methicillin-resistant coagulase-negative staphylococci.