Staphylococci, coagulase negative
Staphylococci, coagulase negative is a topic covered in the Johns Hopkins ABX Guide.
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MICROBIOLOGY
- Coagulase-negative staphylococci (CoNS) are aerobic, Gram-positive coccus, occurring in clusters.
- Predominantly found on skin and mucous membranes.
- Heterogeneous group
- Catalase positive but coagulase negative (S. aureus is coagulase positive).
- Major pathogens:
- S. epidermidis: colonies typically small, white-beige (about 1-2 mm in diameter).
- S. haemolyticus:
- S. lugdunensis:
- Over forty recognized species of CoNS capable of causing human disease.
- Many strains with propensity to produce biofilm, allowing for adherence to medical devices.
- Susceptibility profile for CoNS:
- Vancomycin (CLSI): MIC cutoffs
- Sensitive: ≤ 4 mg/L
- Intermediate: 8-26 mg/L
- Resistant: ≥ 32 mg/L
- Note: EUCAST states resistance is MIC > 4 mg/L
- Vancomycin resistance usually due to cell-wall thickening mechanisms.
- Oxacillin:
- Sensitive: ≤ 0.25 mg/L
- Resistant: > 0.5 mg/L
- Note: for S. lugdunesis sensitive if ≤ 2 mg/L and resistant for 4 mg/L.
- Usually resistant of penicillin and typically (80%) to methicillinor oxacillin.
- mecA gene encodes for low-affinity penicillin-binding protein.
- Resistance can be heterotypic, so usually like to see multiple isolates determined as susceptible to beta-lactams, as only a minority of isolates typically express resistance phenotypes.
- Linezolid resistance described, but remains rare.
- Vancomycin (CLSI): MIC cutoffs
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Last updated: September 3, 2016
Citation
Auwaerter, Paul G, and John G Bartlett. "Staphylococci, Coagulase Negative." Johns Hopkins ABX Guide, The Johns Hopkins University, 2016. Johns Hopkins Guide, www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540517/3.0/Staphylococci_coagulase_negative.
Auwaerter PG, Bartlett JG. Staphylococci, coagulase negative. Johns Hopkins ABX Guide. The Johns Hopkins University; 2016. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540517/3.0/Staphylococci_coagulase_negative. Accessed December 5, 2019.
Auwaerter, P. G., & Bartlett, J. G. (2016). Staphylococci, coagulase negative. In Johns Hopkins ABX Guide. Available from https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540517/3.0/Staphylococci_coagulase_negative
Auwaerter PG, Bartlett JG. Staphylococci, Coagulase Negative [Internet]. In: Johns Hopkins ABX Guide. The Johns Hopkins University; 2016. [cited 2019 December 05]. Available from: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540517/3.0/Staphylococci_coagulase_negative.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Staphylococci, coagulase negative
ID - 540517
A1 - Auwaerter,Paul,M.D.
AU - Bartlett,John,M.D.
Y1 - 2016/09/03/
BT - Johns Hopkins ABX Guide
UR - https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540517/3.0/Staphylococci_coagulase_negative
PB - The Johns Hopkins University
DB - Johns Hopkins Guide
DP - Unbound Medicine
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