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Evaluation of a PCR method to determine the clinical significance of blood cultures with Staphylococcus epidermidis in patients with hematological malignancies
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Department of Medicine, Hematology, Örebro University Hospital, Örebro, Sweden.
Örebro University, School of Medical Sciences. Clinical Research Centre, Örebro University Hospital, Örebro, Sweden.
Örebro University Hospital. Department of Infectious diseases, Örebro University Hospital, Örebro, Sweden.
Örebro University Hospital. Department of Laboratory Medicine, Örebro University Hospital, Örebro, Sweden.
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2014 (English)In: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463, Vol. 122, no 6, p. 539-544Article in journal (Refereed) Published
Abstract [en]

The aim was to investigate whether the detection and quantification of Staphylococcus epidermidis DNA in blood could distinguish S. epidermidis blood stream infections (BSIs) from blood culture contaminations in patients with hematological malignancies. The hld gene was chosen to identify S. epidermidis DNA and DNA in blood samples was detected by real-time PCR. Blood samples were obtained simultaneously with blood cultures positive for S. epidermidis (n = 30), during blood culture-negative episodes (n = 10) and episodes of bacteremia with other bacteria than S. epidermidis (n = 4) and from healthy blood donors (n = 10). In addition, DNA from S. epidermidis and a selection of other bacterial species were analyzed. Three different sets of criteria were used to classify episodes with positive blood cultures with S. epidermidis as BSIs or contaminations. All DNA preparations from S. epidermidis (n = 48) were hld-positive, but other bacterial species (n = 13) were negative. Sixteen (53%) of 30 blood samples from patients with blood cultures positive for S. epidermidis were hld-positive, but none of the controls. There was no clear association between a positive hld PCR and episodes interpreted as BSIs. In conclusion, hld PCR failed to distinguish S. epidermidis BSIs from blood culture contaminations in patients with hematological malignancies.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2014. Vol. 122, no 6, p. 539-544
Keywords [en]
coagulase-negative staphylococci; Staphylococcus epidermidis; hematological malignancy; blood culture contamination
National Category
Immunology in the medical area Microbiology in the medical area
Identifiers
URN: urn:nbn:se:oru:diva-32422DOI: 10.1111/apm.12182ISI: 000336447200011PubMedID: 24106819Scopus ID: 2-s2.0-84901231876OAI: oai:DiVA.org:oru-32422DiVA, id: diva2:664632
Note

Funding Agency:

Örebro County Council Research committee 

Available from: 2013-11-15 Created: 2013-11-15 Last updated: 2018-06-04Bibliographically approved
In thesis
1. Coagulase-negative staphylococci in hematological malignancy
Open this publication in new window or tab >>Coagulase-negative staphylococci in hematological malignancy
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Bacterial infections are common in hematological malignancy. Coagulase-negative staphylococci (CoNS) are among the most prevalent causes of bacteremia in patients with hematological malignancies.

In this thesis, different aspects of CoNS in hematological malignancy have been studied in four papers:

In paper 1, CoNS blood culture isolates from patients with hematological malignancies treated at the University Hospital of Örebro from 1980 to 2009 were revaluated for the presence of reduced sensitivity to glycopeptides. A high incidence of heterogeneous-intermediate glycopeptide resistance was observed and there was a trend towards increasing incidence of this phenotype over time.

In paper 2, the colonization pattern of CoNS among patients undergoing intensive chemotherapy for hematological malignancy was investigated. A successive homogenization and an accumulation of CoNS phenotypes mutually present in a majority of included patients were demonstrated.

In paper 3, a PCR method to determine the clinical significance of positive blood cultures of the CoNS species Staphylococcus epidermidis was evaluated. The test failed to discriminate bloodstream infection from blood culture contamination.

Finally, in paper 4, the long-term molecular epidemiology of S. epidermidis blood culture isolates from patients with hematological malignancies was studied with multilocus sequence typing. A predominance of sequence type 2 was demonstrated during the entire 30 year study period.

In conclusion, the results are consistent with that CoNS have established as important pathogens by its capacity to colonize the human skin, its ability to reside and spread in the hospital environment and its rapid adaptation to stressors such as antimicrobials.

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2013. p. 56
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 95
Keywords
coagulase-negative staphylococci, hematological malignancy, Staphylococcus epidermidis, healthcare-associated infection, antibiotic susceptibility, molecular epidemiology, bloddstream infection, bacteremia
National Category
Hematology
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-30750 (URN)978-91-7668-970-7 (ISBN)
Public defence
2013-10-15, Wilandersalen, Universitetssjukhuset i Örebro, S. Grev Roseng. 18, 703 62 ÖREBRO, 09:00 (Swedish)
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Supervisors
Available from: 2013-09-09 Created: 2013-09-09 Last updated: 2017-10-17Bibliographically approved

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Ahlstrand, ErikBäckman, AndersTidefelt, UlfSöderquist, Bo

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Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS)
Immunology in the medical areaMicrobiology in the medical area

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