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1072 STAPHYLOCOCCUS EPIDERMIDIS (S. EPI.) SEPSIS IN THE INTENSIVE CARE NURSERY (ICN)

S.epi is known to cause infection in neonates with indwelling catheters or ventricular shunts. Recently it has been associated with infections in infants with no such foreign bodies. In our ICN from July through October S.epi was the most common cause of sepsis, responsible for 6/10 cases. BW and gest. age in these 6 infants was 1425±434 grams and 31±3 weeks (mean±SD). All infants had umbilical venous (1) or arterial (5) catheters which were removed 7-45 days prior to onset of symptoms. 4 infants had peripheral venous catheters in place. Onset of symptoms occurred between 11 and 54 days of age. In all infants symptoms were indolent and present for >24 hours prior to evaluation for sepsis. They included: tachypnea and hypoxemia (2), apnea and bradycardia(3), feeding intolerance(3), lethargy (5), and fever (1). 3 infants were started on ampicillin and gentamicin with no improvement, 2 were begun on vancomycin, and 1 was untreated prior to 2 sets of positive blood cultures. S.epi sensitive to vancomycin and chloramphenicol was isolated from the blood of all 6 infants. After 24 hours of vancomycin all improved dramatically. All urine and CSF cultures were sterile.Although S.epi frequently contaminates cultures, the organism must be regarded as a potential pathogen in the ICN and treated aggressively.