Hall R T, Hall S L, Barnes W G, Izuegbu J, Rogolsky M, Zorbas I
Pediatr Infect Dis J. 1987 Apr;6(4):377-83. doi: 10.1097/00006454-198704000-00007.
Twenty-nine infants were identified as having coagulase-negative staphylococcal (C-S) bacteremia. Fourteen infants had pneumonia and 10 had central line-associated bacteremia. Twenty-four of 29 (83%) had invasion of the mucocutaneous barrier at the time the positive blood culture was drawn. Clinical signs and symptoms were nonspecific. Apnea/bradycardia was the most prevalent clinical feature, occurring in 20 (69%) infants. Staphylococcus epidermidis was the most frequent blood culture isolate, occurring in 21 (72%) cases. Slime production by C-S blood culture isolates occurred in 23 (79%) cases. There was no prevalent antibiotic resistance pattern, phage type or plasmid profile among blood culture isolates from infants with bacteremia. Mucocutaneous isolates of C-S from infants with bacteremia were compared with those from infants without invasive disease. Infants with bacteremia had a significantly higher percentage of slime-producing organisms (75% vs. 58%, P = 0.027) and a significantly higher percentage of S. epidermidis species (79% vs. 53%, P = 0.001) than isolates from infants without bacteremia. Our data support the relationship of slime production and the S. epidermidis species of C-S as virulence factors in infants with foreign bodies. Testing C-S for slime production is a relatively simple laboratory procedure which may be an additional aid in the evaluation of their clinical significance.
29名婴儿被确定患有凝固酶阴性葡萄球菌（C-S）菌血症。14名婴儿患有肺炎，10名患有中心静脉导管相关菌血症。在血培养阳性时，29名婴儿中有24名（83%）存在皮肤黏膜屏障的侵入。临床症状和体征不具特异性。呼吸暂停/心动过缓是最常见的临床特征，20名（69%）婴儿出现该症状。表皮葡萄球菌是血培养中最常见的分离菌株，21例（72%）出现该菌。C-S血培养分离株产生黏液的情况在23例（79%）中出现。菌血症婴儿的血培养分离株中不存在普遍的抗生素耐药模式、噬菌体类型或质粒图谱。将菌血症婴儿的C-S皮肤黏膜分离株与无侵袭性疾病婴儿的分离株进行比较。与无菌血症婴儿的分离株相比，菌血症婴儿产生黏液的生物体百分比显著更高（75%对58%，P = 0.027），表皮葡萄球菌物种的百分比也显著更高（79%对53%，P = 0.001）。我们的数据支持C-S产生黏液和表皮葡萄球菌物种作为异物相关婴儿毒力因子的关系。检测C-S是否产生黏液是一个相对简单的实验室程序，可能有助于进一步评估其临床意义。
