Association of coagulase-negative staphylococcal slime production and adherence with the development and outcome of adult septicemias

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Abstract
The relationship of coagulase-negative staphylococcal slime production and adherence with the development and outcome of bloodstream infections in two Finnish hospitals was evaluated. Analysis of 64 strains from 52 adult septicemias disclosed 34 (53%) adherent slime producers. In comparison, only 142 (29%) of 489 single blood culture isolates were adherent slime producers. Although tube adherence test-positive strains were significantly (P < 0.001) more common among the septicemia strains than among clinically insignificant isolates, almost half of the septicemia cases were caused by tube test-negative strains. Thus, regarding any single patient isolate, a cautious posture to the clinical impact of positivity in the tube adherence test seems warranted. Moreover, adherence and slime production, as such, apparently played no role in the clinical outcome of these infections. The epidemiologic findings revealed that slime-producing coagulase-negative staphylococci were common in the hospital environment and suggested that epidemic spread of such strains was influenced by antimicrobial therapy. Collectively, these results indicate that, at least in these two hospitals, positivity in the tube test was of minor importance in guiding clinical decisions in treating adult septicemias.

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