Molecular typing of coagulase-negative staphylococci from blood cultures does not correlate with clinical criteria for true bacteremia.

摘要: Abstract PURPOSE: Determining whether a blood culture that contains coagulase-negative staphylococci represents bacteremia or contamination is clinical dilemma. We compared molecular-typing results of staphylococcal isolates with criteria for true bacteremia. SUBJECTS AND METHODS: Pulsed-field gel electrophoresis and arbitrary primed polymerase chain reaction (PCR) were used to determine patients two more cultures had the same strain organism in each (same bacteremia). evaluated three different bacteremia: patient received than 4 days antibiotics, there was an explicit note medical chart which physician diagnosed bacteremia, Centers Disease Control surveillance primary bloodstream infection. Agreement between same-strain definition examined, based on assumption most infections should be result single strain. RESULTS: The study sample consisted 42 106 isolates. Nineteen bacteremias (45%) Classification as same–strain correlated poorly all assessments (range percent agreement, 50% 57%; range kappa statistic, 0.01 0.15). There both false-positive false-negative errors. Patients positive likely have those only [11 15 (73%) vs 8 27 (30%), P = 0.006]. discriminating PCR (percent 83%; kappa, 0.67). CONCLUSION: Molecular typing suggesting either are frequently multiple strains commonly not accurate distinguishing from Vancomycin treatment clinically defined may unnecessary.