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Abstract
ABSTRACT
Objective: Coagulase-negative staphylococci (CoNS) are leading causes of healthcare-associated bloodstream infections (BSIs) and pose a significant clinical challenge in intensive care units (ICUs). This study aimed to identify clinical and laboratory parameters associated with 30-day mortality in ICU patients with CoNS-related BSI.
Methods: This retrospective study included patients aged 18 years or older who were hospitalized in the ICU between January 1 and November 1, 2024, and had the same CoNS species isolated from two separate blood culture sets. Demographic characteristics, clinical findings, laboratory results, and microbiological data were evaluated. Factors associated with 30-day mortality were investigated using receiver operating characteristic (ROC) curve analysis and multivariate logistic regression analysis.
Results: A total of 173 patients were included in the study. The median age was 75 years (interquartile range [IQR], 66–81), and 42.8% were female. Staphylococcus epidermidis was the most frequently isolated species (42.2%), and 95.3% of isolates were methicillin-resistant. Septic shock was present in 45% of patients. The 30-day mortality rate was 71.6%. Compared with survivors, nonsurvivors had significantly higher procalcitonin (PCT) levels (1.46 vs 0.58 ng/mL; p=0.002) and lactate levels (2.25 vs 1.97 mmol/L; p=0.044), whereas platelet counts were significantly lower (182 500 vs 282 000/mm³; p<0.001). In multivariate analysis, platelet count ≤194 000/mm³ [odds ratio (OR): 5.94; 95% confidence interval (CI): 2.53–13.97; p<0.001] and PCT level >0.67 ng/mL (OR: 3.14; 95% CI: 1.50–6.57; p=0.002) were independently associated with 30-day mortality.
Conclusion: In patients with CoNS-related BSI, elevated PCT levels and low platelet counts were independently associated with 30-day mortality. These findings may contribute to early prognostic assessment and risk stratification in critically ill patients.
Keywords: Bloodstream infection, coagulase-negative staphylococci, mortality, procalcitonin