Who does NOT need a TEE with staph aureus bacteremia?

TEE has been recommended for all patients with nosocomial staph aureus bacteremia, but it is invasive and not readily available in many places. In 2 retrospective cohorts, researchers determined if the absence of certain criteria could negate the need for TEE in some patients. They found if the patient had none of these criteria (nonvertebral osteo, spinal infection, continued bacteremia for >4 days, permanent intracardiac device, or hemodialysis), the overall negative predictive value of the criteria (for having endocarditis) was 99.5%. Absence of these criteria predicts the ability to pass on the TEE (abstract)