Update on Staphylococcus aureus bacteraemia

Abstract

Purpose of reviewTo review recently published evidence relevant to Staphylococcus aureus bacteremia (SAB).Recent findingsStaphylococcus aureus is the most common pathogen causing co-infections and superinfections in patients with COVID-19. Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia ratios have sharply risen during the pandemic. SAB mortality is 18% at 1 month and 27% at 3 months but has gradually decreased over the last 30 years. Recurrences and reinfections are common (9%). Standardised items to define complicated SAB, and a new cut-off defining persisting bacteremia after 2 days with positive blood cultures have been proposed. Multiple antibiotic combinations have been trialled including vancomycin or daptomycin with β-lactams, fosfomycin, or clindamycin, without significant results. In the recently published guidelines, vancomycin remains the first line of treatment for MRSA bacteremia. For the management of methicillin-susceptible Staphylococcus aureus, cefazolin less frequently causes acute kidney injury than flucloxacillin, and when susceptibility is demonstrated, de-escalation to penicillin G is suggested.SummaryOur review confirms that Staphylococcus aureus represents a special aetiology among all causes of bloodstream infections. Pending results of platform and larger trials, its distinct epidemiology and determinants mandate careful integration of clinical variables and best available evidence to optimize patient outcomes.

Fatal bacteremia caused by Staphylococcus argenteus: A case report

“…The most frequent infections are local infections, which become bacteremia when staphylococci invade into the bloodstream and colonize to cause BSI. [11] Staphylococci have a great ability to infect human hosts by adherence, invasion, persistence and evasion of the host immunity. [12] S argenteus is a novel and emerging species that is part of the S aureus complex.…”

Central line associated and primary bloodstream infections

“…A difference in rate of primary BSI among those with BSIs present on admission versus ICU-onset BSIs was not reported [8 & ]. Although Staphylococcus aureus is recognized to be an important cause of primary BSI due to its propensity to cause complicated infections [17], there is a paucity of contemporary studies that have specifically examined the influence on infecting species among primary BSI in the critically ill. In a single center cohort of 104 critically ill patients, Singh et al…”

“…Although Staphylococcus aureus is recognized to be an important cause of primary BSI due to its propensity to cause complicated infections [17], there is a paucity of contemporary studies that have specifically examined the influence on infecting species among primary BSI in the critically ill. In a single center cohort of 104 critically ill patients, Singh et al [9] identified central line insertion, diabetes mellitus and higher APACHE-II scores as risk factors for Gram-positive cocci BSI.…”

Rapid visualization molecular fluorescence detection of methicillin‐resistant Staphylococcus aureus using the multiplex MIRA‐qPCR method

“…[ 6,7 ] MRSA can enter the body through wounds or infected invasive medical devices, resulting in secondary symptoms of infection such as pneumonia, surgical site infections, and bacteremia. [ 8 ] Without timely diagnosis and treatment, bacteremia caused by MRSA infection may lead to sudden death. [ 9 ] Therefore, in addition to good hygiene practices and appropriate epidemiological surveillance systems, the rapid and accurate detection of MDR bacteria in the early stages of infection plays a crucial role in effectively preventing the worsening of infection and community transmission.…”