Clinical Significance and Predictors of Outcomes of Coagulase-negative Staphylococci in Blood Cultures – An Observational Study
Aishwarya Jeyasekar, Divya Elizabeth Mathew, Bennett Phillip, Jonathan Arul Jeevan Jayakaran, Balaji Veeraraghavan, Ramya IyaduraiAbstract
Background:
Coagulase-negative staphylococci (CoNS) are common in blood culture isolates because they are the part of the skin microbiota. CoNS infections typically occur in association with implantable foreign bodies, such as central venous devices. Our study aims to identify clinically significant bacteremia (CSB) among CoNS isolates.
Material and Methods:
This retrospective observational study was conducted at a tertiary care hospital in South India over 5 years (2019–2024). Adults aged ≥18 years with at least one blood culture showing CoNS growth were included in the study. CSB was defined as patients presenting with fever, chills, or hypotension, one positive CoNS blood culture, and clinical improvement after antibiotic therapy or central venous catheter removal, with no alternative diagnoses. Patient data, including antimicrobial susceptibility, were obtained from the hospital records. Chi-square and Fisher’s exact tests were used to identify the associations between variables.
Results:
Of the 2319 blood cultures, 258 (11.1%) had grown CoNS, and 30 (11.7%) were CSB. CSB patient mortality was 21% and males had higher mortality. Admission to intensive care unit (ICU) (odds ratio [OR]-5.095, 95% confidence interval [CI] 2.522–10.294,
Conclusion:
Our study found that 11.6% of CoNS were clinically significant, with ICU admission and the presence of implantable and prosthetic devices as risk factors.