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Infectious Diseases in Clinical Practice:
doi: 10.1097/IPC.0b013e3182309603
NFID Clinical Updates

Staphylococcus aureus Bacteremia and Endocarditis: The Role of Diagnostic Evaluation

Corey, G. Ralph MD



In the article by Corey, appearing in Infectious Diseases in Clinical Practice, Vol. 19, No. 5, pp. 307–312, entitled “Staphylococcus aureus Bacteremia and Endocarditis: The Role of Diagnostic Evaluation,” the following commercial support information was inadvertently omitted from the submission: “This activity is supported by an unrestricted educational grant from Cubist Pharmaceuticals.”

Infectious Diseases in Clinical Practice. 21(1):74, January 2013.

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Staphylococcus aureus, a unique and potentially lethal organism, can cause bacteremia resulting in metastatic complications. S. aureus has characteristics that distinguish it from other bloodstream pathogens. These include membrane-bound attachment proteins enabling the bacteria to infect tissues in all parts of the body. Risk factors for developing complicated S. aureus bacteremia (SAB) include acquiring the infection in a community setting, a history of previous endocarditis, recent intravenous procedures such as dialysis, heart structure/valve abnormalities, and the presence of intravascular and prosthetic hardware. Physical examination findings may include any tissue of the body (eg, Roth spots in the eye, embolic manifestations, psoas abscess, and vertebral osteomyelitis). Differentiating between complicated and uncomplicated SAB is a key objective. Predictors of complicated SAB include a positive follow-up blood culture at 48 to 96 hours, community onset, persistent fever at 72 hours, skin lesions, and an abnormal transesophageal echocardiogram. All patients with SAB should be treated for at least 4 weeks. Only in well-defined cases, under the care of an infectious disease specialist, should patients with SAB be treated for a shorter period.

© 2011 Lippincott Williams & Wilkins, Inc.

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