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Staphylococcus capitis Central-Line Associated Bloodstream Infections (CLABSI) in the NICU: A Single-Center 4-Year Experience on Central Line Management during Sepsis Treatment
Sala, A.; Pivetti, V.; Vittorini, A.; Viggiano, C.; Castoldi, F.; Fabiano, V.; Lista, G.; Cavigioli, F. Staphylococcus capitis Central-Line-Associated Bloodstream Infections in the Neonatal Intensive Care Unit: A Single-Center, Four-Year Experience in Central-Line Management during Sepsis Treatment. Pathogens2024, 13, 234.
Sala, A.; Pivetti, V.; Vittorini, A.; Viggiano, C.; Castoldi, F.; Fabiano, V.; Lista, G.; Cavigioli, F. Staphylococcus capitis Central-Line-Associated Bloodstream Infections in the Neonatal Intensive Care Unit: A Single-Center, Four-Year Experience in Central-Line Management during Sepsis Treatment. Pathogens 2024, 13, 234.
Sala, A.; Pivetti, V.; Vittorini, A.; Viggiano, C.; Castoldi, F.; Fabiano, V.; Lista, G.; Cavigioli, F. Staphylococcus capitis Central-Line-Associated Bloodstream Infections in the Neonatal Intensive Care Unit: A Single-Center, Four-Year Experience in Central-Line Management during Sepsis Treatment. Pathogens2024, 13, 234.
Sala, A.; Pivetti, V.; Vittorini, A.; Viggiano, C.; Castoldi, F.; Fabiano, V.; Lista, G.; Cavigioli, F. Staphylococcus capitis Central-Line-Associated Bloodstream Infections in the Neonatal Intensive Care Unit: A Single-Center, Four-Year Experience in Central-Line Management during Sepsis Treatment. Pathogens 2024, 13, 234.
Abstract
Coagulase negative Staphylococci (CoNS) are reported to be responsible for 50-60% of bloodstream infections in very preterm (<1500 g) infants in Neonatal Intensive Care Units (NICU). Staphylococcus capitis is an increasingly prevalent pathogen in neonatal setting, frequently causing central-line associated bloodstream infections (CLABSI) that can be difficult to eradicate. CVC removal versus in situ treatment of CoNS CLABSIs is a matter of debate, with no clear consensus emerging in the existing literature. We revised all S. capitis CLABSIs in our NICU between 2019 and 2022, focusing on the role of catheter removal for eradication. Among 25 cases, 17 CVCs were removed after diagnosis, leading to a 76.5% eradication rate in this group. 3 infants had a persistently positive blood culture after CVC substitution. A new catheter was than inserted after a 48-hours washout period, resulting in resolution of the infection. Only 2 of 8 patients (25%) who retained the catheter after diagnosis, underwent infection eradication with antibiotic therapy alone. Catheter removal, when feasible, seems to be the most effective strategy to eradicate S. capitis CLABSIs, sometimes even requiring a 48-hours washout period before reinsertion. Further studies on this subject are needed to better standardize the management of this kind of infections.
Keywords
LOS; CLABSI; CoNS; CVC; infants; S. capitis
Subject
Medicine and Pharmacology, Pediatrics, Perinatology and Child Health
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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