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Mark Parta, Daniel M. Musher, Benefits and Costs of Rapid Drug Susceptibility in Staphylococcus aureus Bacteremia, Clinical Infectious Diseases, Volume 52, Issue 8, 15 April 2011, Page 1079, https://doi.org/10.1093/cid/cir088
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TO THE EDITOR—We read with interest the recent paper by Bauer et al [1] describing outcomes of treatment with the use of polymerase chain reaction (PCR)–based rapid reporting of bacterial identification and drug susceptibility in patients with Staphylococcus aureus bacteremia. We congratulate the authors for addressing this timely issue but would like to raise several concerns.
First, the relationship between the outcomes of interest and the intervention is not at all clear. The authors have not suggested, and we cannot imagine, how a 1.7-day reduction in duration of antibiotic therapy translates into a 6.2-day reduction in hospital stay.
Second, the authors excluded patients who had bacteremia due to coagulase-negative staphylococci (CONS). In a similar PCR-based study of patients with gram-positive cocci in their bloodstream, we [2] recently showed that the greatest benefit of PCR identification resulted from avoidance of or shortened duration of empiric therapy for methicillin-resistant S. aureus (MRSA) in patients with CONS bacteremia. We believe that decreasing cost by eliminating unnecessary therapy for MRSA in patients with CONS bacteremia is a goal that can be achieved using PCR.
