Essentials in the management of S. aureus bloodstream infection

Staphylococcus aureus bloodstream infection is one of the most common serious bacterial infections worldwide. It represents a heterogenous clinical entity with a high risk of metastatic complications and a high in-hospital mortality ranging between 20 and 30%. The outcome can be improved by optimised diagnostic and therapeutic management. Thus, our minireview should provide important and often missed pieces of information in the management of S. aureus bloodstream infection.

We describe the essentials in the management of S. aureus bloodstream infection.

Five essentials were identified: 1) S. aureus bacteremia should always be considered clinically significant. 2) Length of bacteremia and fever is relevant for diagnostic workup, duration of therapy and prognosis. 3) Prompt identification and eradication of portal of entry and infective/metastatic foci are essential. 4) Infective endocarditis should be excluded. 5) Intravenous treatment for at least two weeks up to 4-6 weeks with antistaphylococcal penicillins for MSSA and vancomycin or daptomycin for MRSA bloodstream infection is indicated.

Further efforts should be undertaken to increase the adherence to the essentials in the management of S. aureus bloodstream infection.