Catheter-related bloodstream infections with coagulase-negative staphylococci: are antibiotics necessary if the catheter is removed?

Hebeisen, Ursula Patricia; Atkinson, Andrew; Marschall, Jonas; Buetti, Niccolò Ivo Marco-Aurelio (2019). Catheter-related bloodstream infections with coagulase-negative staphylococci: are antibiotics necessary if the catheter is removed? Antimicrobial Resistance and Infection Control, 8(21), p. 21. BioMed Central 10.1186/s13756-019-0474-x

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Background

Catheter-related bloodstream infections (CRBSI) with coagulase-negative Staphylococci (CoNS) are a common source of hospital-acquired bloodstream infections. The main objective of this study was to elucidate the role of systemic antibiotic therapy in the setting of catheter removal in adult patients with CoNS-CRBSI.

Methods

We conducted a retrospective cohort study on patients with CoNS-CRBSI diagnosed between 2008 and 2016 with follow-up for up to 12 months. The main inclusion criterion was a removed intravascular catheter with quantitative catheter tip culture growing CoNS and the same CoNS identified in the blood culture of a given patient. Outcomes were (i.e. either presence of prolonged bacteremia or symptoms attributed to CoNS-CRBSI > 2 days after catheter removal), , and after catheter removal. We compared outcomes between a group with antibiotic treatment prescribed according to current IDSA guidelines (≥5 days, "treatment" group) and a "no-treatment" group.

Results

Our study population comprised 184 CoNS-CRBSI episodes. Seventy-six percent received antibiotic treatment ≥5 days, while 17% did not receive therapy. were absent from the patients who did not receive antibiotics. Severe neutropenia, hematologic cancer and immunosuppression were significantly more frequent in the treatment group. The subgroup analysis with 32 matched pairs showed no significant difference in frequency of non-resolved infection (0% in the no-treatment vs 15.6% in the ≥5 days treatment group,  = 0.06). The remaining outcomes were similar in the two groups.

Conclusions

Our findings indicate that withholding antimicrobial therapy in CoNS-CRBSI is neither associated with short-term complications nor with long-term recurrences.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology

UniBE Contributor:

Atkinson, Andrew; Marschall, Jonas and Buetti, Niccolò Ivo Marco-Aurelio

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2047-2994

Publisher:

BioMed Central

Language:

English

Submitter:

Annelies Luginbühl

Date Deposited:

12 Apr 2019 16:26

Last Modified:

23 Oct 2019 10:33

Publisher DOI:

10.1186/s13756-019-0474-x

PubMed ID:

30719282

Uncontrolled Keywords:

CRBSI Central venous catheter Coagulase-negative staphylococci Intravascular catheter

BORIS DOI:

10.7892/boris.126468

URI:

https://boris.unibe.ch/id/eprint/126468

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