From the Guidelines
For the treatment of central line-associated Staphylococcus hominis infections, vancomycin is typically the first-line therapy at a dose of 15-20 mg/kg IV every 8-12 hours, with consideration of removal of the infected central line whenever possible, as retention often leads to treatment failure 1.
Key Considerations
- Staphylococcus hominis is a coagulase-negative staphylococcal species that can cause central line-associated bloodstream infections (CLABSI) 1.
- The infected central line should be removed whenever possible, as retention often leads to treatment failure 1.
- If line removal is not feasible, antibiotic lock therapy may be considered alongside systemic antibiotics 1.
- Treatment duration is generally 7-14 days, depending on clinical response and complications 1.
- Blood cultures should be repeated to confirm clearance of bacteremia 1.
- S. hominis infections are concerning because this organism can form biofilms on catheter surfaces and may harbor resistance genes, including methicillin resistance 1.
Preventive Measures
- Proper hand hygiene, maximal sterile barrier precautions during insertion, and adherence to catheter maintenance bundles are essential preventive measures for central line infections 1.
- The use of antimicrobial agents, such as vancomycin, should be guided by susceptibility testing and local resistance patterns 1.
Alternative Therapies
- Alternative therapies, such as daptomycin (6-8 mg/kg IV daily) or linezolid (600 mg IV/oral twice daily), may be considered in cases of vancomycin resistance or intolerance 1.
From the Research
Central Line Staph Hominis
- Central line-associated bloodstream infections (CLABSIs) are a significant concern in healthcare settings, with coagulase-negative staphylococci (CoNS), including Staphylococcus hominis, being a common cause 2.
- Staphylococcus hominis is a type of CoNS that can cause CLABSIs, particularly in patients with central venous catheters 3, 2.
- The treatment of CLABSIs caused by CoNS, including S. hominis, often involves the use of antibiotics such as vancomycin, ciprofloxacin, daptomycin, and linezolid 3, 4, 5.
- However, the emergence of antibiotic-resistant CoNS strains, including those with vancomycin heteroresistance, can complicate treatment and lead to poor clinical outcomes 5.
- Antimicrobial lock therapy (ALT) has been proposed as a potential treatment approach for CLABSIs, including those caused by S. hominis, with agents such as daptomycin and tigecycline showing promise 6.
Risk Factors and Prevention
- The use of central venous catheters is a significant risk factor for the development of CLABSIs, including those caused by S. hominis 2.
- Strict aseptic technique during catheter insertion and maintenance can help prevent CLABSIs 2.
- The use of antiseptic- or antibiotic-impregnated catheters, daily chlorhexidine baths/washes, and placement of a chlorhexidine-impregnated sponge over the insertion site may also reduce the risk of CLABSIs 2.
Treatment Options
- Vancomycin is commonly used to treat CLABSIs caused by CoNS, including S. hominis, but the emergence of vancomycin-resistant strains can limit its effectiveness 3, 4, 5.
- Daptomycin has shown efficacy against CoNS, including S. hominis, and may be a useful alternative for the treatment of CLABSIs 3, 6.
- Linezolid has also been used to treat CLABSIs caused by CoNS, but the development of resistance can be a concern 4.