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Coagulase-Negative Staphylococci Isolated from Cerebrospinal Fluid Shunts: Importance of Slime Production, Species Identification, and Shunt Removal to Clinical Outcome

Janara J. Younger, Gordon D. Christensen, Douglas L. Bartley, James C. H. Simmons and Fred F. Barrett
The Journal of Infectious Diseases
Vol. 156, No. 4 (Oct., 1987), pp. 548-554
Published by: Oxford University Press
Stable URL: http://www.jstor.org/stable/30136552
Page Count: 7
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Coagulase-Negative Staphylococci Isolated from Cerebrospinal Fluid Shunts: Importance of Slime Production, Species Identification, and Shunt Removal to Clinical Outcome
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Abstract

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-negative Staphylococcus 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 sue 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.

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