This study sought to evaluate infections related to health care caused by
coagulase-negative Staphylococci in a neonatal intensive care
unit by assessing antimicrobial susceptibility profiles and potentially effective
This was a retrospective descriptive study performed on a case series of
healthcare-associated infections, and the antimicrobial susceptibility profiles
were evaluated. Newborns from other hospitals who were admitted to a neonatal
intensive care unit in Rio de Janeiro between January 1, 2010,
and June 30, 2012, were studied.
In total, 765 patients were admitted, totaling 3,051 patient-days, and the
incidence density of general infection was 18.9 per 1,000 patient-days. The rate
of central venous catheter use was 71.6%, and the positive culture rate for all
sites and all infections related to health care were 68.4%. Coagulase-negative
Staphylococci were identified in 11 (19.2%) of 57 health
care-related infections, and infections with extended-spectrum beta-lactamase
producing Klebsiella pneumoniae and Candida sp.
constituted 5 cases each. Of the 11 cases of coagulase-negative
Staphylococci, 10 (90.9%) were primary bloodstream infections.
The sensitivity of the coagulase-negative Staphylococci isolates
to vancomycin, clindamycin, ciprofloxacin, oxacillin and gentamycin was 100%,
81.8%, 72.7%, 27.2% and 22.2%, respectively. There were no deaths directly
attributed to coagulase-negative Staphylococci infection.
Coagulase-negative Staphylococci was the main agent identified in
healthcare-associated infections, with low rates of infections related to central
venous catheter. In hospitals with a high oxacillin resistance profile, similar to
those included in this study, vancomycin may be used as an initial therapy,
although clindamycin represents a viable alternative.