Coagulase-negative staphylococci isolated from cerebrospinal fluid shunts: importance of slime production, species identification, and shunt removal to clinical outcome.
Coagulase-negative staphylococci isolated from cerebrospinal fluid shunts: importance of slime production, species identification, and shunt removal to clinical outcome.
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从脑脊液分流中分离出的凝固酶阴性葡萄球菌：粘液产生、物种鉴定和分流去除对临床结果的重要性。
DOI：
10.1093/infdis/156.4.548
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发表时间：
1987
期刊：
影响因子：
--
通讯作者：
Barrett,FF
中科院分区：
文献类型：
--
作者：
Younger,JJ;Christensen,GD;Bartley,DL;Simmons,JC;Barrett,FF
我们从脑脊液分流管中收集并鉴定了85株凝固酶阴性葡萄球菌（51种病原体和34种污染物）。所有分离株进行了分类的物种和特点的抗菌药物的敏感性和定量坚持塑料组织培养板。病原体间粘附菌数明显多于污染物间粘附菌数（P<0.01）。两组的菌种分布相似;然而，20%的病原体和无污染物为磷酸酶阴性表皮葡萄球菌（P<0.05）。在两组中均检测到45%的患者对四种或四种以上抗菌药物耐药。种属命名和抗菌药物耐药性均与临床结局无关。然而，6例非粘附性凝固酶阴性葡萄球菌感染中的5例（83%）（与39例粘附性凝固酶阴性葡萄球菌感染中的16例[41%]相比;P<0.05）通过单独抗菌治疗治愈。治愈与移走定植的分流管高度相关-仅接受抗菌治疗的感染患者中有38%治愈，接受抗菌治疗和部分分流管移走的患者中有75%治愈，所有接受抗菌治疗和全分流管置换的患者均治愈。
We collected and characterized 85 strains of coagulase-negative staphylococci (51 pathogens and 34 contaminants) from cerebrospinal fluid shunts. All isolates were classified by species and characterized by antimicrobial susceptibility and quantitative adherence to plastic tissue culture plates. There were more adherent organisms among pathogens than among contaminants (P< .01). Species distribution was similar for both groups; however, 20% of the pathogens and none of the contaminants were phosphatase-negativeStaphylococcus epidermidis(P< .05). Resistance to four or more antimicrobial agents was detected in 45% of both groups. Neither species designation nor antimicrobial resistance correlated with clinical outcome. Five (83%) of six infections due to nonadherent (vs. 16 [41%] of 39 due to adherent;P< .05) coagulase-negative staphylococci were, however, cured with antimicrobial therapy alone. Cure was highly associated with removal of the colonized shunt — 38% of infected patients treated with antimicrobial therapy alone were cured, 75% treated with antimicrobial therapy and partial shunt removal were cured, and all treated with antimicrobial therapy and total shunt replacement were cured.