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[教学医院凝固酶阴性葡萄球菌医院感染菌血症的临床意义、流行病学及微生物学]

[Clinical significance, epidemiology and microbiology of coagulase-negative staphylococcal nosocomial bacteremia at a teaching hospital].

作者信息

Góngora-Rubio F, Pignatari A C, Costa L M, Bortolloto V I, Machado A M, De Góngora D V

机构信息

Comissão de Controle de Infecção Hospitalar, Hospital de Base, Fundação Faculdade Regional de Medicina de São José do Rio Preto, SP.

出版信息

Rev Assoc Med Bras (1992). 1997 Jan-Mar;43(1):9-14.

PMID:9224985
Abstract

Coagulase-negative staphylococci (CNS) are an important cause of nosocomial bacteremia and they are frequently considered as contaminants of blood-cultures. From October 1990 to September 1992, 300 positive blood-cultures for CNS at the Hospital São Paulo were studied and 141 CNS bacteremias were characterized as nosocomial bacteremias. Clinical and microbiological criteria were defined to differentiate between true CNS bacteremia and contaminated cultures. Only 20.6% of the CNS nosocomial bacteremia were considered as true bacteremia. Most of the CNS true nosocomial bacteremia were detected among newborns admitted to the neonatal intensive care unit; the presence of intravascular catheter and parenteral nutrition were significant findings. We did not detect significant difference between true nosocomial bacteremia and contaminated cultures regarding to resistance to oxacillin and SLIME production. The clinical criteria and the positivity of the blood-cultures up to 48 hours after incubation, utilized in our definitions, were useful parameters to characterize the CNS true nosocomial bacteremia.

摘要

凝固酶阴性葡萄球菌(CNS)是医院获得性菌血症的重要病因,常被视为血培养的污染物。1990年10月至1992年9月,对圣保罗医院300份CNS血培养阳性样本进行了研究,其中141例CNS菌血症被认定为医院获得性菌血症。制定了临床和微生物学标准,以区分真正的CNS菌血症和污染培养物。仅20.6%的CNS医院获得性菌血症被视为真正的菌血症。大多数CNS真正的医院获得性菌血症在入住新生儿重症监护病房的新生儿中被检测到;血管内导管和肠外营养的存在是重要发现。在对苯唑西林的耐药性和黏液产生方面,我们未检测到真正的医院获得性菌血症与污染培养物之间存在显著差异。我们定义中使用的临床标准以及培养48小时内血培养的阳性结果,是表征CNS真正医院获得性菌血症的有用参数。

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