Staphylococcus aureus bacteremia

One of the most common causes of bloodstream infections worlwide and causes extensive morbidity and mortality with death rates ranging from 20 to 40%.

Annual incidence is 4.3-38.2 for 100,000 person-years in the US.

Associated with a high morbidity rate in 30 day mortality rate of 20-40%.

Women have an 18% increased odds of mortality from Staph aureus bacteremia.

Glucocorticoid use is associated with a substantial increase risk of community acquired staphylococcal aureus bacteremia.

Individuals using systemic glucocorticoids have a 2.5 fold increase in the risk of community acquired staphylococcal aureus bacteremia.

The association of glucocorticoids follows a dose relationship.

Methicillin resistance is an independent risk factor for mortality.

Obtaining follow up blood cultures to document resolution of bacteremia after the initiation of treatment health is an appropriate management tool.

Draining abscesses and removing infected prostheses is consistent with appropriate management.

SA infective endocarditis is common and often clinically indistinguishable from Staph bacteremia and may be fatal if inadequately treated.

Patients with SA infective endocarditis should be considered no patients with Staph aureus bacteremia.

All patients should be evaluated with echocardiography, preferably by transesophageal echo cardiography,except in low risk infective endocarditis patients.

Vancomycin and daptomycin are first line antibiotic therapies for methicillin-resistant Staph aureus bacteremia.

With patients with uncomplicated MRSA bacteremia, at least 14 days of Antibiotic therapy from the first negative culture should be adequate management.

For all other patients a course of 4-6 weeks is recommended.

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