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Journal of Clinical Microbiology, July 1998, p. 2089-2092, Vol. 36, No. 7
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Clinical Importance of Identifying Coagulase-Negative Staphylococci Isolated from Blood Cultures: Evaluation of MicroScan Rapid and Dried Overnight Gram-Positive Panels versus a Conventional Reference Method

Melvin P. Weinstein,1,* Stanley Mirrett,2 Linda Van Pelt,3 Mary McKinnon,3 Barbara L. Zimmer,3 Wesley Kloos,4 and L. Barth Reller2,5

Departments of Medicine and Pathology, UMDNJ-Robert Wood Johnson Medical School, and Microbiology Laboratory, Robert Wood Johnson University Hospital, New Brunswick, New Jersey1; Dade MicroScan, Sacramento, California3; and North Carolina State University, Raleigh,4 Departments of Pathology and Medicine,5 and Microbiology Laboratory,2 Duke University Medical Center, Durham, North Carolina

Received 24 November 1997/Returned for modification 14 January 1998/Accepted 31 March 1998

We evaluated the clinical usefulness of species identification of blood isolates of coagulase-negative staphylococci as a predictor of the clinical significance of the isolates. In addition, we compared results of species identification obtained with MicroScan Rapid Gram-Positive Identification panels and Dried Overnight (Conventional) Gram-Positive Identification panels with those obtained by a tube reference method. Two hundred eighty-five blood isolates were tested, including 92 judged to represent true bacteremia and 193 judged to represent contamination. The most common species detected were Staphylococcus epidermidis, Staphylococcus hominis, and Staphylococcus haemolyticus. These three species accounted for nearly 98% of the clinically significant isolates and 89% of the contaminants. The isolation of other species almost always represented contamination. However, identification of the three most common species did not help distinguish pathogens from contaminants. Both the Rapid and the Dried Overnight Gram-Positive panels identified S. epidermidis strains accurately, but the panels performed less well for the other species. Analysis revealed that S. hominis was frequently misidentified due to the presence of a previously unknown subspecies. Based on the initial results, revised investigational Dried Overnight Gram-Positive Identification panels (CPID-2) were prepared and tested. The CPID-2 panels identified 85 to 95% of S. epidermidis strains, 76 to 86% of S. hominis strains, and 88 to 92% of S. haemolyticus strains with high probability (>85%) and, overall, represented a significant improvement over the other panels for identification of these staphylococcal species.

* Corresponding author. Mailing address: UMDNJ-Robert Wood Johnson Medical School, 1 Robert Wood Johnson Pl., New Brunswick, NJ 08903-0019. Phone: (732) 235-7713. Fax: (732) 235-7951. E-mail: weinstei{at}umdnj.edu.

Journal of Clinical Microbiology, July 1998, p. 2089-2092, Vol. 36, No. 7
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.


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