This study sought to expand current knowledge on the clinical and epidemiological characteristics of persistent
coagulase-negative Staphylococcus (CoNS)
bacteremia in very-low-birth-weight (VLBW) infants. Background and disease-related data were collected prospectively on 143 VLBW infants diagnosed with CoNS
bacteremia at a pediatric tertiary medical center in 1995-2003. Findings were compared between those with persistent (positive blood cultures for >72 h under appropriate treatment ) and nonpersistent disease. Fifty-eight infants (40.6%) were found to have persistent
bacteremia. There were no between-group differences in maternal characteristics, mode of delivery, newborn characteristics, dwell time of central venous and umbilical
catheters, complications of prematurity, or mean
hospital stay. The persistent
bacteremia group had significantly higher rates of
hypothermia at presentation (37.9% vs. 17.6%, p < 0.04),
creatinine >1.2 mg% on treatment day 7 (13.7% vs. 2.4%, p < 0.02; transient phenomenon), and
endocarditis (p < 0.03); one infant had an aortic
thrombus. Predominantly breast-fed infants had a higher rate of negative cultures within 72 h of appropriate treatment than predominantly formula-fed infants (60% vs. 19%, p < 0.02). In conclusion, persistence of CoNS
bacteremia is common in VLBW infants.
Endocarditis should be excluded in all infants with persistent disease. Breast-feeding is associated with a shorter disease duration.