Persistent S. aureus bacteraemia

Persistent S. aureus bacteraemia refers to positive blood culture results on day 5 or later after starting appropriate antibiotics. In patients with persistent MSSA, PSSA or MRSA bacteraemia, consider whether:

• source control has been achieved
• additional imaging should be performed
• antibiotic therapy should be modified.

In patients with persistent bacteraemia treated with vancomycin, check the vancomycin minimum inhibitory concentration (MIC) on the most recent isolate to identify reduced susceptibility to vancomycin. Therapy should be changed if the MIC is 2 mg/L or more – seek expert advice.