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586 Higher Levels of Inflammatory Markers in Vlbw Infants with Catheter Sepsis Caused by Coagulase Negative Staphylococci Resistant to Oxacillin
  1. J Smisek,
  2. V Fiala,
  3. R Plavka
  1. Division of Neonatology, Department of Obstetrics and Gynecology, General Faculty Hospital, Prague, Czech Republic

Abstract

Background and Aims Coagulase negative Staphylococci (CoNS) are most prevalent pathogens in central line associated bloodstream infections (CLABSI) in very low birth weight (VLBW) infants. The aim of this study was to compare CLABSI caused by CoNS in terms of virulence and clinical relevance.

Methods A retrospective observation analysis of all CLABSI caused by CoNS in VLBW infants admitted to our NICU during a 5-year period (2006–2010) was performed. Two groups of CLABSI were compared: the OXAS caused by CoNS susceptible to oxacillin and the OXAR caused by CoNS resistant to oxacillin, in terms of perinatal demographic data, related laboratory signs and clinical data.

Results There were 54 episodes of CLABSI caused by CoNS found in 51 infants, 14 in the OXAS group (average BW±SD: 855g ± 293; average GA±SD: 25.9 wks ± 2.8) and 40 in the OXAR group (average BW±SD: 788 g ± 241; average GA±SD: 26.2 wks ± 2.3). The OXAR group presented a higher maximum CRP levels (median±95%CL: 28±15 mg/l vs. 21±12 mg/l, p=0.047), as well as the maximum values of the I/T index (median±95%CL: 0.23±0.04 vs. 0.19±0.05, p=0.051), higher number of positive blood cultures (median±95%CL: 1±0.14 vs. 2±0.3, p=0,006) and the tendency to a higher incidence of necrotizing enterocolitis (38% vs. 14%, p=0.078).

Conclusions Resistance to oxacillin in CoNS CLABSI has a relevant influence on higher levels of inflammatory markers and the tendency to NEC in VLBW infants.

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