Journal Article

Bloodstream Infections Caused by Small-Colony Variants of Coagulase-Negative Staphylococci Following Pacemaker Implantation

Christof von Eiff, Pierre Vaudaux, Barbara C. Kahl, Daniel Lew, Stefan Emler, Andrej Schmidt, Georg Peters and Richard A. Proctor

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 29, issue 4, pages 932-934
Published in print August 1999 | ISSN: 1058-4838
Published online August 1999 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/520462
Bloodstream Infections Caused by Small-Colony Variants of Coagulase-Negative Staphylococci Following Pacemaker Implantation

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Small-colony variants (SCVs) of Staphylococcus aureus cause persistent and relapsing infections. Relatively little is known regarding infections caused by SCVs of coagulase-negative staphylococci. We report two cases of pacemaker electrode infections due to SCVs of Staphylococcus epidermidis and Staphylococcus capitis. Sequence analysis of a portion of the 16S rRNA gene (16S rDNA) confirmed the identity of the staphylococcal species as S. capitis and S. epidermidis. Isolates from cultures of blood obtained over at least a 2-week interval were compared by pulsed-field gel electrophoresis and found to be clonal even though the colony morphology was very different. Analysis for auxotrophism revealed hemin dependencies for all isolated SCVs. The two cases have several clinical and laboratory characteristics (which are also seen with S. aureus SCV infections) and strongly suggest that SCVs of coagulase-negative staphylococci must be actively sought, because they grow very slowly and can be easily missed.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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