skip to main content

MRSA Bacteraemia — SCE Infectious Diseases MCQ

Instant feedback + full explanation. One question, done properly.

ModerateHealthcare-Associated InfectionsMRSA BacteraemiaSCE Infectious Diseases

A 65-year-old man on long-term haemodialysis presents with fever and rigors after a dialysis session. Blood cultures from both the dialysis line and peripheral site grow MRSA. The central venous dialysis catheter was inserted 3 weeks ago. TOE shows no vegetation. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Remove the catheter and treat with IV Vancomycin for 2 weeks

MRSA catheter-related bloodstream infection in a dialysis patient without endocarditis requires catheter removal plus systemic antibiotics. The standard duration for uncomplicated MRSA bacteraemia (negative TOE, clearance of blood cultures within 72 hours, no metastatic foci) is a minimum of 2 weeks from the first negative blood culture. In dialysis patients, Vancomycin is dosed post-dialysis with trough monitoring. If bacteraemia is complicated (persistent positive cultures, endocarditis, metastatic infection), 4–6 weeks is required.

Reference: BSAC 2023 – MRSA bacteraemia guidelines; NICE NG139 2019 – Healthcare-associated infections