Karakullukçu Asiye, Kuşkucu Mert Ahmet, Ergin Sevgi, Aygün Gökhan, Midilli Kenan, Küçükbasmaci Ömer
Cerrahpasa Medical School of Istanbul University, Medical Microbiology, Istanbul, Turkey.
Diagn Microbiol Infect Dis. 2017 Mar;87(3):291-294. doi: 10.1016/j.diagmicrobio.2016.12.006. Epub 2016 Dec 14.
The aim of this study was to investigate the criteria used to distinguish coagulase-negative staphylococci (CoNS) bacteremia from contamination. We evaluated 162 adult patients with CoNS-positive blood cultures (BCs). Of the 162 patients, 35 (21.6%) had at least 2 positive BCs and 127 (78.4%) had a single positive BC. According to the Laboratory-Confirmed Bloodstream Infection (LCBI) criteria, 24 (14.8%) patients with the same species of CoNS had true bacteremia, and 138 (85.2%) patients had contaminants. Despite the detection of the same CoNS species, 9 of the 24 patients had different CoNS genotypes. Using clinical assessments, only 20 patients were diagnosed with true bacteremia, 8 of them had a single positive BC. We concluded that only using the LCBI criteria or clinical evaluations of a patient were not sufficient to distinguish CoNS bacteremia from contamination. Molecular identification should also be performed as a diagnostic laboratory parameter for CoNS bacteremia.
本研究的目的是调查用于区分凝固酶阴性葡萄球菌（CoNS）菌血症与污染的标准。我们评估了162例血培养CoNS阳性的成年患者。在这162例患者中，35例（21.6%）至少有2次血培养阳性，127例（78.4%）仅有1次血培养阳性。根据实验室确诊血流感染（LCBI）标准，24例（14.8%）感染相同CoNS菌种的患者患有真正的菌血症，138例（85.2%）患者为污染物。尽管检测到相同的CoNS菌种，但24例患者中有9例具有不同的CoNS基因型。通过临床评估，仅20例患者被诊断为真正的菌血症，其中8例仅有1次血培养阳性。我们得出结论，仅使用LCBI标准或对患者进行临床评估不足以区分CoNS菌血症与污染。分子鉴定也应作为CoNS菌血症的诊断实验室参数进行。
