| dc.description.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. | |
