Does species matter? Comparative epidemiology of bloodstream infections due to coagulase negative staphylococci
Emily Larsen1,2, Samantha Keogh2,3, Felicity Edwards2,3, Jayesh Dhanani2,4, Nicole Marsh1,2,3,4, Kevin Laupland2,3,
1Griffith University, Nathan, Queensland, Australia2Royal Brisbane and Women’s Hospital, Herston, Queensland, Australia3Queensland University of Technology, Kelvin Grove, Queensland, Australia4University of Queensland, Herston, Queensland, Australia
Introduction
Hospital-acquired bloodstream infections (HABSI) continue as a prevalent, yet preventable, danger posed to hospitalised inpatients in tertiary care. Coagulase-negative staphylococci (CoNS) species (collectively) are the most common cause of HABSI, yet there is a dearth of evidence examining the comparative epidemiology of specific species. We aimed to examine the incidence, clinical features, and outcomes associated with CoNS HABSI, and conduct a comparative analysis among the most common species.
Methods
We conducted an analysis of a population-based surveillance dataset, and included all CoNS BSI events which occurred in the publicly funded Queensland health system between 2000-2019. Results were reported descriptively.
Results
In total, 5,686 CoNS BSI were identified. This included 2,258 (39.7%) events which were not identified to species level. Among the 3,428 speciated CoNS BSI, 2,235 (65.2%), 311 (9.1%), 358 (10.4%), 373 (10.9%), and 151 (4.4%) were S. epidermidis, S. capitis, S. haemolyticus, S. hominis, and other staphylococcal species, respectively. Among the four most common species identified there was significant differences in the proportion among females (p=0.050); median age (p<0.001); resistance to flucloxacillin (p<0.001); and the distribution of hospital-onset, healthcare-associated, and community-associated disease (p<0.001). Thirty-day all-cause case-fatality was 10.9%, 15.4%, 14.8%, and 9.1% for S. epidermidis, S. capitis, S. haemolyticus, and S. hominis (p=0.010), respectively. Results pending completion of analysis.
Conclusions
Although CoNS are of often considered collectively as a group, they differ on several clinical determinants and associated survival outcomes. Gold standard surveillance reporting is similarly undermined by the inability to match organisms as a species level.
Biography
Emily Larsen is a Research Fellow, Vascular Access, with a joint position between the Royal Brisbane and Women’s Hospital, and Griffith University. Since 2014, Ms Larsen has been a Project Manager for more than 30 single and multi-centre clinical trials, cohort and qualitative studies, publishing over 40 peer-reviewed articles over the last 5 years. Ms Larsen’s interests and expertise include: the healthcare consumer experience of IV access; vascular access devices in Cancer Care; and the classification, and prevention of, catheter-associated bloodstream infections.