Attention: This is an archive version of the HELP CDSS for documentation purposes. It is neither updated nor actively maintained!
Result of the blood culture
I. S. aureus or S. lugdunensis
Is there a Oxacillin resistance (≙MRSA)?
Does the patient need vasopressors ?
Does the patient have intra- or extravascular foreign bodies ?
Is the bacteremia community-acquired?
If any of the points apply: Request infectious disease consultation
CAVE:
The detection of S. aureus in an urine culture can also be an indication of an underlying S. aureus bacteremia (SAB), which is why blood cultures should also be taken before starting antibiotic therapy.
Explanatory Notes:
Any detection of S. aureus or S. lugdunensis in the blood culture must be assessed as clinically relevant and treated accordingly, as contamination is only present in <5% of cases and serious complications are possible!
Significance of foreign bodies: Possible focus of infection and formation of biofilms as a possible cause of therapy failure and recurrence! (e.g: Vascular catheters including long-term catheters (port, Hickmann, etc.), valve prosthesis, cardiac implanted electronic devices (pacemaker, CRT, etc.), joint endoprosthesis, osteosynthesis material)
Implanted foreign bodies are a possible focus of bacteremia. In addition, the formation of biofilms on foreign material can be a reason for therapy failure or recurrence.
The term community-acquired bacteremia is used if the positive blood culture was taken within the first 48 hours after admission to hospital.