Epidemiology, microbiology, and pathogenesis of coagulase-negative staphylococci
- JoAnn M Tufariello, MD, PhD
JoAnn M Tufariello, MD, PhD
- Albert Einstein College of Medicine
- Franklin D Lowy, MD
Franklin D Lowy, MD
- Professor of Medicine and Pathology & Cell Biology (in Epidemiology)
- Columbia University, College of Physicians and Surgeons
- Section Editors
- Daniel J Sexton, MD
Daniel J Sexton, MD
- Editor-in-Chief — Infectious Diseases
- Section Editor — Bacterial Infections
- Professor of Medicine
- Duke University Medical Center
- Sheldon L Kaplan, MD
Sheldon L Kaplan, MD
- Editor-in-Chief — Pediatrics
- Section Editor — Pediatric Infectious Diseases
- Professor and Vice Chairman for Clinical Affairs
- Baylor College of Medicine
Coagulase-negative staphylococci (CoNS) are the most frequent constituent of the normal flora of the skin [1,2]. These organisms are common contaminants in clinical specimens as well as increasingly recognized as agents of clinically significant infection, including bacteremia and endocarditis . Patients at particular risk for CoNS infection include those with prosthetic devices, pacemakers, intravascular catheters, and immunocompromised hosts.
The epidemiology, microbiology, and pathogenesis of coagulase-negative staphylococci will be reviewed here. Issues related to clinical manifestations and treatment of CoNS infections are discussed separately. (See "Clinical manifestations of infection due to coagulase-negative staphylococci" and "Treatment of infections due to coagulase-negative staphylococci".)
Use of intravascular devices is an important contributor to bloodstream infections with coagulase-negative staphylococci (CoNS).
Data from the National Nosocomial Infections Surveillance (NNIS) system collected between 1992 and 1997 revealed that CoNS accounted for 36 percent of all bloodstream isolates in intensive care units, making these organisms the most common cause of nosocomial bloodstream infections . A survey from the Surveillance and Control of Pathogens of Epidemiologic Importance (SCOPE) database of nosocomial bloodstream infections in United States hospitals between 1995 and 2002 also identified CoNS as the most common cause of hospital-acquired bloodstream infections, accounting for 31 percent of cases .
Among patients with blood cultures positive for CoNS, the fraction with significant bloodstream infection ranges from 12 to 25 percent of cases [6-9]. Such distinction is important for clinical management. (See 'Infection versus contamination' below.)
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