Antibiotic Treatment and Precautions for Staphylococcus Species Detected by PCR in Blood Culture

Initial Antibiotic Selection

For an inpatient with Staphylococcus species detected by PCR in blood culture, empiric treatment with vancomycin is recommended while awaiting full susceptibility results, as recommended by the Centers for Disease Control and Prevention (CDC) 1, 2
Vancomycin is the treatment of choice for serious infections caused by Staphylococcus species when methicillin resistance cannot be ruled out, as is the case with preliminary PCR results showing only Staphylococcus species without resistance markers, according to the CDC 2
PCR results are typically available 39 hours earlier than conventional testing, allowing for more rapid targeted therapy once methicillin susceptibility is determined, as reported in Clinical Microbiology Reviews 3

For coagulase-negative staphylococci (CoNS), assess clinical significance - a single positive blood culture may represent contamination, as noted by the CDC 2

For S. aureus bacteremia, consider echocardiography to rule out endocarditis, as recommended by the American Heart Association 4

Do not continue empiric vancomycin for presumed infections when cultures are negative for beta-lactam-resistant gram-positive organisms, as advised by the CDC 2
Avoid treating a single positive blood culture for coagulase-negative staphylococci if other cultures are negative, as this likely represents contamination, according to the CDC 2
PCR results should guide early therapy decisions, as they can identify Staphylococcus species approximately 39 hours earlier than conventional methods, as reported in Clinical Microbiology Reviews 3

For patients with severe penicillin allergy who cannot receive β-lactams, vancomycin remains appropriate for MSSA, as recommended by the CDC 2