Comparison of contamination and infection of CoNS bacteremia in hospitalized children’s blood cultures

Purpose: We have aimed to evaluate the clinical significance of infections caused by coagulase- negative staphylococci in pediatric patients. Methods: Study included 511 patients aged 1 month-18 years with growth of coagulase-negative staphylococci (CoNS) in their blood cultures obtained between October 2020-October 2021. The presence of blood stream infection (BSI), catheter- related bloodstream infection (CRBSI) or contamination was investigated. Results: The median age of the patients was 2.2 years (min:1 month, max:18 years). The study population consisted of 57.9% male, and 42.1% female patients. Contamination was detected in 82.2%, bloodstream infection (BSI) in 10.8% and catheter-related bloodstream infection (CRBSI) in 7% of patients, while S. epidermidis was identified in 58.5%, S. hominis in 40.3% and S. haemolyticus in 13.9% of them. The rate of methicillin-resistant CoNS was found to be 36.8%. Fever, indwelling catheter use, total parenteral nutrition were significantly more common in the CRBSI/BSI group than in the contamination group (p=0.017; p<0.001; p=0.001, respectively). The growth of S. haemolyticus was found to be mostly associated with CRBSI/BSI, and S. epidermidis was considered more often as an contaminant agent (p<0.001; p=0,022, respectively) The duration of hospital stay was longer in the CRBSI/BSI group, and antibiotherapy changed more frequently in the CRBSI/BSI group (p<0.001, p<0.005, respectively). Conclusions: Accompanying fever, using an intravascular device, and TPN may be warning signs for CRBSI or BSI. The most effective way to reduce unnecessary use of antibiotics, laboratory workload and medical expenditures is to prevent contamination by performing correct blood collection procedures.