Toward Defining Complicated Coagulase-Negative Staphylococcal Bacteremia

TO THE EDITOR -We read with great interest the recent study by Papadimitriou-Olivgeris et al. in which they tried to validate our criteria for complicated coagulase-negative staphylococcal (CoNS) bacteremia. 1,2They concluded that our criteria failed to identify patients at higher mortality risk.While we appreciate their work, we believe certain methodological aspects merit further consideration.First, the validation was conducted retrospectively merging two separate cohorts, one of them including patients with suspected infective endocarditis (IE), which, as the authors acknowledge, may have led to an overrepresentation of suspected IE cases, potentially limiting the generalizability of their findings.The authors state that only "true CoNS bacteremia" cases were included, but the criteria used to distinguish true infections from contamination are not specified.This raises the possibility that a higher proportion of contaminants may have been included, given the notably low mortality (9%) compared to our study (17%) and previous reports.