Spectrum: Local Antimicrobial Stewardship, for Markham Stouffville Hospital

Coagulase-Negative Staphylococcus

Definitions

Coagulase-negative staphylococcal Bacteremia can be divided into 3 categories:

Simple

  • Single blood culture positive for coagulase-negative staphylococci

  • Negative follow-up blood culture

  • No signs or symptoms of local infection at a catheter site

  • No symptoms or signs of metastatic infection

  • No indwelling intravascular prosthetic devices

Uncomplicated

  • 2 or more blood cultures positive for coagulase-negative staphylococci drawn 24 hours or more apart, OR

  • Single blood culture positive for coagulase-negative staphylococci, PLUS symptoms or signs of infection at a catheter site

Complicated

  • 2 or more blood culture positive for coagulase negative staphylococci from samples drawn over 24 hours apart, OR

  • Echocardiography with evidence of endocarditis, OR

  • Symptoms or signs of metastatic infection

Empiric Regimen

Vancomycin 15-20mg/kg IV Q8-12H

Dose to a target trough level of 15-20mg/L

Duration of Therapy

Simple: 0-3 days
Uncomplicated: 5 days
Complicated: 7-28 days

Comments

Part of normal skin flora, low virulence.

Common contaminant.

Therapy recommended if 2 or more positive blood cultures and systemic signs of infection present.