Bacteremia due to Staphylococcus epidermidis: microbiologic, epidemiologic, clinical, and prognostic features.

Staphylococcus epidermidis was established as the causal agent of true bacteremia on the basis of microbiologic, epidemiologic, clinical, and prognostic data on 65 episodes of S. epidermidis bacteremia (SEB) recorded in the Hospital Covadonga of Oviedo, Spain, during 1982-1986. All isolates were susceptible in vitro to vancomycin, mercury, silver, cadmium, and malachite green, and 95.2% of isolates were susceptible to cephalothin; a dominant biotype, four resistotypes (ion-dye resistance patterns), and four antibiotypes (antibiotic resistance patterns) were found. A high percentage of isolates (76.7%) produced slime, and several potentially toxic exoproteins were detected in various and generally lower proportions. The main clinical features of SEB were high frequency in male patients greater than 40 years of age, fever, leukocytosis, anemia, and phlebitis. Indwelling devices were the most common portal of entry. The overall death rate was 36.9%. Underlying disease, hemodynamic status, predisposing factors, and treatment were statistically significant parameters in relation to mortality.