Ponce de Leon S, Wenzel R P
Am J Med. 1984 Oct;77(4):639-44. doi: 10.1016/0002-9343(84)90354-1.
During a seven-year study period, 1976 to 1982, this prospective surveillance program detected 108 episodes of nosocomial bacteremia caused by coagulase-negative staphylococci (seven per 10,000 admissions). Chart reviews were subsequently performed in 100 patients primarily to define the patient population and determine outcome of infection. Seventy-two patients had at least two culture bottles that showed growth of coagulase-negative staphylococci plus one or more cultures that showed growth at another site or on a vascular catheter. Most of the patients were in the early or later stages of life: 20 were premature infants, 20 additional infants were under one year of age, and 35 patients were 50 years of age or older. Seventy-three patients were in intensive care areas at the time of the infection. The mortality for the 100 patients studied was 34 percent, with a rate of 9 percent per week after infection. Ninety-three patients had arterial or central lines in place prior to bacteremia and, in 36 reviewed, the mean duration of use of each type of catheter (5.1 days or more) was longer than recommended. In 56 percent of 46 catheters cultured semiquantitatively, there was growth of coagulase-negative staphylococci. The presence of coagulase-negative staphylococci in the blood is associated with significant mortality in hospitalized patients. No longer can their presence in the blood be disregarded as mere contaminants, especially in patients in critical care units.
在1976年至1982年的七年研究期间，这项前瞻性监测计划检测到108例由凝固酶阴性葡萄球菌引起的医院感染性菌血症（每10000例住院患者中有7例）。随后对100例患者的病历进行了审查，主要是为了确定患者群体并确定感染的结局。72例患者至少有两个培养瓶显示凝固酶阴性葡萄球菌生长，另外还有一个或多个培养物在其他部位或血管导管上生长。大多数患者处于生命的早期或晚期：20例为早产儿，另外20例婴儿年龄在1岁以下，35例患者年龄在50岁或以上。73例患者在感染时处于重症监护区域。所研究的100例患者的死亡率为34%，感染后每周死亡率为9%。93例患者在菌血症发生前已留置动脉或中心静脉导管，在36例经审查的病例中，每种类型导管的平均使用时间（5.1天或更长）超过了推荐时间。在46根进行半定量培养的导管中，56%检测到凝固酶阴性葡萄球菌生长。血液中凝固酶阴性葡萄球菌的存在与住院患者的显著死亡率相关。其在血液中的存在再也不能仅仅被视为污染物而被忽视，尤其是在重症监护病房的患者中。
