[Impact of primary and intravascular catheter-related bacteremia due to coagulase-negative staphylococci in critically ill patients]

Med Intensiva. 2011 May;35(4):217-25. doi: 10.1016/j.medin.2010.09.002. Epub 2010 Dec 3.
[Article in Spanish]


Objective: To study the impact of coagulase-negative staphylococcal (CNS) primary and intravascular catheter-related bloodstream infection (PBSI/CRBSI) on mortality and morbidity in critically-ill patients.

Design: We performed a double analysis using data from the ENVIN-HELICS registry data (years 1997 to 2008): 1) We studied the clinical characteristics and outcomes of patients with CNS-induced PBSI/CRBSI and compared them with those of patients with PBSI/CRBSI caused by other pathogens; and 2) We analyzed the impact of CNS-induced PBSI/CRBSI using a case-control design (1:4) in patients without other nosocomial infections.

Setting: 167 Spanish Intensive Care Units.

Patients: Patients admitted to ICU for more than 24 hours.

Results: 2,252 patients developed PBSI/CRBSI, of which 1,133 were caused by CNS. The associated mortality for PBSI/CRBSI caused by non-CNS pathogens was higher than that of the CNS group (29.8% vs. 25.9%; P=.039) due exclusively to the mortality of patients with candidemia (mortality: 45.9%). In patients without other infections, PBSI/CRBSI caused by CNS (414 patients) is an independent risk factor for a higher than average length of ICU stay (OR: 5.81, 95% CI: 4.31-7.82; P<.001).

Conclusion: Crude mortality of patients with CNS-induced BPSI/CRBSI is similar to that of patients with BPSI/CRBSI caused by other bacteria, but lower than that of patients with candidemia. Compared to patients without nosocomial infections, CNS-induced PBSI/CRBSI is associated with a significant increase in length of ICU stay.

Publication types

  • Comparative Study
  • English Abstract
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Bacteremia / epidemiology*
  • Bacteremia / microbiology
  • Bacteremia / prevention & control
  • Case-Control Studies
  • Catheter-Related Infections / epidemiology*
  • Catheter-Related Infections / microbiology
  • Catheter-Related Infections / prevention & control
  • Coagulase
  • Comorbidity
  • Critical Illness* / epidemiology
  • Cross Infection / epidemiology*
  • Cross Infection / microbiology
  • Cross Infection / prevention & control
  • Female
  • Fungemia / epidemiology
  • Gram-Negative Bacterial Infections / epidemiology
  • Gram-Positive Bacterial Infections / epidemiology
  • Hospital Mortality
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Prevalence
  • Registries
  • Spain / epidemiology
  • Staphylococcal Infections / epidemiology*
  • Staphylococcal Infections / microbiology
  • Staphylococcal Infections / prevention & control


  • Coagulase