Management of Gram-positive bacteraemia

Curr Opin Infect Dis. 2007 Dec;20(6):561-7. doi: 10.1097/QCO.0b013e3282f1bedd.

Abstract

Purpose of review: Gram-positive bacteraemic infections are frequent and associated with high morbidity and mortality. This paper reviews publications focusing exclusively on new findings related to Gram-positive bacteraemia in the published literature from July 2006 to June 2007.

Recent findings: Ninety-eight articles have been reviewed. Of the 66 incorporated in this review, 21 focused on epidemiology or prevention. Thirty-two concerned staphylococcal bacteraemia, while 11 addressed other Gram-positive pathogens. There were seven articles on daptomycin, nine on endocarditis, seven on diagnostic issues, five on haemodialysis-related bacteraemia, and four on antibiotic lock techniques.

Summary: In contrast to the large amount of articles dealing with epidemiological issues, the past year did not reveal any new fundamental insights into the treatment of Gram-positive bacteraemia. The rise in the minimal inhibitory concentrations of Staphylococcus aureus to vancomycin may become a threat. Several publications underlined the in-vivo efficacy of daptomycin, the new kid on the block against Gram-positive bacteraemia and endocarditis. The antibiotic lock technique showed some promising potential for secondary prevention or treatment of catheter-related infection, while rapid molecular techniques for early species identification may become a valuable diagnostic tool. Most evidence was not based on large, randomized trials and needs future confirmation.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Bacteremia / drug therapy*
  • Gram-Positive Bacterial Infections / drug therapy*
  • Humans

Substances

  • Anti-Bacterial Agents