title: [Evaluation of diagnosis and therapy of Staphylococcus aureus bacteraemia: recommended minimum treatment duration of 2 weeks not always met].
abstract: OBJECTIVE
  Bacteraemia caused by Staphylococcus aureus (SA bacteraemia) can run a relatively mild course, but can also be complicated by focal infections in bones, joints, soft tissue and the heart. The Infectious Disease Society of America (IDSA) advises a transoesophageal echocardiogram (TOE) be taken in each case of SA bacteraemia in order to rule out endocarditis, in addition to sampling blood for culture 2-3 days after the start of treatment. Both the IDSA and the Dutch Stichting Werkgroep Antibiotica Beleid (SWAB - Foundation for Antibiotic Policy Work Groups) recommend that patients with SA bacteraemia be treated intravenously for at least 14 days; longer if a complicated course is expected. We investigated whether SA bacteraemia was diagnosed and treated according to current guidelines.
  
  
  METHODS
  Retrospective cohort study
  
  
  METHODS
  A case series of consecutive patients ≥ 18 years of age with SA bacteraemia was identified using the electronic microbiology registration system.
  
  
  RESULTS
  A total of 93 patients were identified. Median follow-up duration was ≥ 3 months. Of the 81 patients who had survived one week after admission to the hospital, 41(60%) did not undergo TOE. Blood cultures on day 3 were performed in only 6 (6%) patients. Of the 79 (85%) patients who had survived the first two weeks of infection, 26 (33%) had been treated with intravenous antibiotics for less than 14 days. Recurrent SA bacteraemia occurred in 4 patients.
  
  
  CONCLUSIONS
  In the majority of patients with SA bacteraemia, diagnostic work-up and duration of therapy did not comply with ISDA and SWAB guidelines.
authors.affiliation: Isala Klinieken, Zwolle, Afd. Interne Geneeskunde, the Netherlands. g.w.d.landman@isala.nl
authors.forename: Gijs W D
authors.initials: GW
authors.lastname: Landman
authors.forename: Jolande W
authors.initials: JW
authors.lastname: Bouwhuis
authors.forename: Peter
authors.initials: P
authors.lastname: Bloembergen
authors.forename: Jan T M
authors.initials: JT
authors.lastname: van der Meer
authors.forename: Paul H P
authors.initials: PH
authors.lastname: Groeneveld
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D016470:Bacteremia / Q000175:diagnosis* / Q000188:drug therapy*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000188:drug therapy*; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents