A study of patients in two intensive care units (ICUs) suggests Staphylococcus epidermidis bacteria are an underrated cause of bloodstream infections and septic shock, French researchers reported last week in the International Journal of Infectious Diseases.
Although S epidermidis is considered a low virulence pathogen, it frequently colonizes the skin and mucous membranes and can cause infections, particularly in immunosuppressed patients with indwelling devices. To get a better sense of the clinical repercussions and prognosis of S epidermidis bloodstream infections (SE-BSIs), along with levels of antibiotic resistance, researchers conducted a retrospective study on ICU patients at two French hospitals, focusing on their epidemiologic characteristics and clinical outcomes following SE-BSIs.
A total of 59 patients with SE-BSIs were included in the study (58% men, median age of 67 years). Most patients (56%) were immunocompromised, including 44% active cancers and 17% organ transplant patients, and all but one patient had a central venous access device during their ICU stay. Of the patients, 63% required norepinephrine, a first-line agent recommended during resuscitation for septic shock, at the time of positive blood cultures, with no indications of concurrent infections.
Patients with hemodynamic consequences of SE-BSI required more mechanical ventilation at the time of bacteremia (49% vs 18%) and had a higher mortality rate (46% vs 14%). Clinical isolates were 100% susceptible to vancomycin but only 71% susceptible to linezolid.
The study authors say further research is needed to investigate host-related factors and other factors associated with S epidermidis virulence.
"Ultimately, these data should lead to clinical trials aimed at testing new anti-infectious strategies against SE-BSI," they wrote.