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Persistent Methicilin-Resistant Staphylococcus aureus Bacteremia: Resetting the Clock for Optimal Management.

Publication ,  Journal Article
Holland, TL; Bayer, AS; Fowler, VG
Published in: Clin Infect Dis
October 29, 2022

A positive follow-up blood culture for methicillin-resistant Staphylococcus aureus (MRSA) while on seemingly appropriate therapy is a common and ominous development. However, the definition and management of persistent MRSA bacteremia is unstandardized. In this Opinion Paper, we identify the presence of bacteremia for > 1 calendar day as a "worry point" that should trigger an intensive diagnostic evaluation to identify metastatic infection sites. Next, we define the duration of MRSA bacteremia that likely constitutes antibiotic failure and outline a potential management algorithm for such patients. Finally, we propose pragmatic clinical trial designs to test treatment strategies for persistent MRSA bacteremia.

Duke Scholars

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Published In

Clin Infect Dis

DOI

EISSN

1537-6591

Publication Date

October 29, 2022

Volume

75

Issue

9

Start / End Page

1668 / 1674

Location

United States

Related Subject Headings

  • Staphylococcal Infections
  • Pragmatic Clinical Trials as Topic
  • Microbiology
  • Methicillin-Resistant Staphylococcus aureus
  • Humans
  • Bacteremia
  • Anti-Bacterial Agents
  • 3202 Clinical sciences
  • 11 Medical and Health Sciences
  • 06 Biological Sciences
 

Citation

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Holland, T. L., Bayer, A. S., & Fowler, V. G. (2022). Persistent Methicilin-Resistant Staphylococcus aureus Bacteremia: Resetting the Clock for Optimal Management. Clin Infect Dis, 75(9), 1668–1674. https://doi.org/10.1093/cid/ciac364
Holland, Thomas L., Arnold S. Bayer, and Vance G. Fowler. “Persistent Methicilin-Resistant Staphylococcus aureus Bacteremia: Resetting the Clock for Optimal Management.Clin Infect Dis 75, no. 9 (October 29, 2022): 1668–74. https://doi.org/10.1093/cid/ciac364.
Holland TL, Bayer AS, Fowler VG. Persistent Methicilin-Resistant Staphylococcus aureus Bacteremia: Resetting the Clock for Optimal Management. Clin Infect Dis. 2022 Oct 29;75(9):1668–74.
Holland, Thomas L., et al. “Persistent Methicilin-Resistant Staphylococcus aureus Bacteremia: Resetting the Clock for Optimal Management.Clin Infect Dis, vol. 75, no. 9, Oct. 2022, pp. 1668–74. Pubmed, doi:10.1093/cid/ciac364.
Holland TL, Bayer AS, Fowler VG. Persistent Methicilin-Resistant Staphylococcus aureus Bacteremia: Resetting the Clock for Optimal Management. Clin Infect Dis. 2022 Oct 29;75(9):1668–1674.
Journal cover image

Published In

Clin Infect Dis

DOI

EISSN

1537-6591

Publication Date

October 29, 2022

Volume

75

Issue

9

Start / End Page

1668 / 1674

Location

United States

Related Subject Headings

  • Staphylococcal Infections
  • Pragmatic Clinical Trials as Topic
  • Microbiology
  • Methicillin-Resistant Staphylococcus aureus
  • Humans
  • Bacteremia
  • Anti-Bacterial Agents
  • 3202 Clinical sciences
  • 11 Medical and Health Sciences
  • 06 Biological Sciences