Persistent Methicilin-Resistant Staphylococcus aureus Bacteremia: Resetting the Clock for Optimal Management.
Thomas L HollandArnold S BayerVance G FowlerPublished in: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (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.
Keyphrases
- methicillin resistant staphylococcus aureus
- staphylococcus aureus
- gram negative
- clinical trial
- end stage renal disease
- biofilm formation
- small cell lung cancer
- chronic kidney disease
- ejection fraction
- squamous cell carcinoma
- newly diagnosed
- study protocol
- machine learning
- prognostic factors
- multidrug resistant
- patient reported outcomes
- cystic fibrosis
- risk assessment
- pseudomonas aeruginosa
- cell therapy
- open label
- phase ii
- neural network