Wetenschappelijk onderzoek voor S aureus bactermie diagnostiek stewardship

Abstract

Abstract Background Staphylococcus aureus bacteremia (SAB) is a serious infection requiring timely diagnosis and close monitoring. Follow-up blood cultures are commonly used to assess treatment response and detect persistent infection. Routine or excessive testing may lead to unnecessary procedures and costs without improving care. Methods We performed a retrospective study adult patients treated at UMCU and Diakonessenhuis from January 1, 2014, to January 1, 2024. Timing, frequency, and microbiological results were evaluated for diagnostic yield and clinical usefulness. Cultures were categorized by interval from the index test and prior results, and interpreted in the context of bacteremia clearance or persistence. Results A total of 8,340 follow-up blood culture requests were collected across 1,200 SAB episodes in 1,142 patients. Follow-up cultures were frequently performed at short intervals: 20.2% within 48 hours of the index request, and 41.9% within 1 to 48 hours after a previous test. Only 28% of follow-up cultures were deemed clinically useful—either by confirming microbiological clearance or detecting ongoing SAB. The remaining requests had limited added value, especially when performed prematurely or after clearance had already been established with more than 48 hours. Conclusions: This study highlights that most follow-up blood cultures in SAB management offer limited diagnostic benefit, especially when performed at short intervals or after clearance. Routine, untargeted repeat testing should be re-evaluated in favor of a more selective, evidence-based approach. Improved blood culture stewardship—supported by clear clinical guidelines—can help reduce redundant testing.