Can an Echocardiogram Be Avoided in Nosocomial Staphylococcal Bacteremia?

In a post hoc analysis of two studies, infective endocarditis developed in only 1 of 222 patients who had none of the proposed clinical prediction criteria.

Transesophageal echocardiography to exclude infective endocarditis (IE) has been recommended for all patients with nosocomial Staphylococcus aureus bacteremia (SAB). However, this technique is expensive, is not widely available, and can bring its own complications.

Investigators recently proposed clinical prediction criteria to identify patients with nosocomial SAB who are at low risk for developing IE and thus may not require echocardiography. These criteria were prolonged SAB (>4 days), presence of a permanent intracardiac device, hemodialysis dependency, spinal infection, and nonvertebral osteomyelitis. Using data from two previously completed prospective studies investigating the epidemiology of SAB — INSTINCT, conducted at two tertiary …

Reviewing Author

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)