DNA fingerprinting analysis of coagulase negative staphylococci implicated in catheter related bloodstream infections

Aims: The epidemiological assessment of cases of coagulase negative staphylococcal catheter related bloodstream infection. Methods: Two hundred and thirty patients with suspected catheter related bloodstream infection were evaluated over a two year period. Central venous catheters were cultured both...

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Bibliographic Details
Published in:Journal of clinical pathology 2002-11, Vol.55 (11), p.824-828
Main Authors: Dobbins, B M, Kite, P, Kindon, A, McMahon, M J, Wilcox, M H
Format: Article
Language:English
Subjects:
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Bacteremia - diagnosis
Bacteremia - microbiology
Bacterial Typing Techniques
Biological and medical sciences
catheter
Catheterization
Catheterization, Central Venous - adverse effects
cfu
Coagulase - analysis
colony forming units
Cross Infection - diagnosis
Cross Infection - microbiology
DNA Fingerprinting - methods
DNA testing
Electrophoresis, Gel, Pulsed-Field
Emergency and intensive care: techniques, logistics
Equipment Contamination
Evaluation
Humans
infection
Intensive care medicine
intravascular
Medical sciences
Methods
Original
Perfusions. Catheterizations. Hyperbaric oxygenotherapy
PFGE
PMSF
polymethylsulfonyl fluoride
pulsed field gel electrophoresis
Risk factors
staphylococcal
Staphylococcal infections
Staphylococcal Infections - diagnosis
Staphylococcal Infections - microbiology
Staphylococcal Infections - transmission
Staphylococcus - classification
Staphylococcus - genetics
Statistics
TBE
TEN
Tris/boric acid/EDTA buffer
Tris/EDTA buffer
Tris/EDTA/NaCl buffer
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Summary:Aims: The epidemiological assessment of cases of coagulase negative staphylococcal catheter related bloodstream infection. Methods: Two hundred and thirty patients with suspected catheter related bloodstream infection were evaluated over a two year period. Central venous catheters were cultured both endoluminally and extraluminally. Peripheral blood, catheter hubs, skin entry, and skin control sites were also cultured. Pulsed field gel electrophoresis (PFGE) was used to DNA fingerprint coagulase negative staphylococci isolated from patients with presumptive catheter related bloodstream infection. Results: Sixty cases of catheter related bloodstream infection were identified, 21 of which were attributed to coagulase negative staphylococci. Two hundred and ninety four separate isolates of coagulase negative staphylococci from the 21 cases of catheter related bloodstream infection were subjected to PFGE (mean of 14 for each case). Catheter related bloodstream infection was only confirmed by PFGE analysis in 16 of the 21 cases because in the remaining five cases peripheral blood and central venous catheter coagulase negative staphylococci isolates were different. Skin entry, control skin, and central venous catheter hub isolates matched peripheral blood isolates in six, four, and seven cases, respectively. Coagulase negative staphylococci isolates could not be cultured from the patients’ own skin in seven cases of catheter related bloodstream infection. Central venous catheter lumens were colonised in all cases of catheter related bloodstream infection compared with 44–81% of cases that had positive external surface catheter tip cultures, depending on the threshold used to define significant growth. Conclusions: Catheter related bloodstream infection as a result of coagulase negative staphylococci may be over stated in about a quarter of cases, unless a discriminatory technique is used to fingerprint isolates. No single, simplistic route of bacterial contamination of central venous catheters was identified, but endoluminal catheter colonisation is invariably present in cases of catheter related bloodstream infection.
ISSN:0021-9746
1472-4146
DOI:10.1136/jcp.55.11.824