Coagulase-negative staphylococcal disease: emerging therapies for the neonatal and pediatric patient

Abstract

Purpose of review: Due to the high frequency, significant clinical impact, and cost of coagulase-negative staphylococcal infections, a great deal of effort continues in the investigation of the epidemiology, prevention, and treatment of coagulase-negative staphylococcal infection in the neonate and infant.

Recent findings: Pediatric oncology and burn patients appear to be high-risk groups for coagulase-negative staphylococcal infections. Coagulase-negative staphylococcus appears to be the major pathogen world-wide, and associated with significant morbidity and mortality in neonatal intensive care units, in pediatric intensive care units, and following ophthalmologic surgery. A screened human polyclonal antibody and a humanized chimeric monoclonal antibody are both under investigation (in phase II-III clinical trials) for prevention of coagulase-negative staphylococcal infections in high-risk neonates. Resistance of coagulase-negative staphylococcus to antibiotics appears to be increasing. Should neonates with sepsis and central catheters have their catheters removed immediately or only when the infection is persistent? Arbekacin and linezolid are two new antibiotics that appear to be effective in the treatment of coagulase-negative staphylococcal infections, but their precise role has not yet been identified.

Summary: This article summarizes the significant clinical reports about coagulase-negative staphylococcal infections since December 2002.