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高危金黄色葡萄球菌菌血症患者行或不行 PET-CT 检查的死亡率:单中心经验。

Mortality in patients with high risk Staphylococcus aureus bacteremia undergoing or not PET-CT: A single center experience.

机构信息

Department of Internal Medicine and Infectious Diseases, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, 10 av Hippocrate, 1200, Brussels, Belgium.

IREC, Pole Pneumologie, ORL et Dermatologie, Université Catholique de Louvain, Brussels, Belgium.

出版信息

J Infect Chemother. 2019 Nov;25(11):880-885. doi: 10.1016/j.jiac.2019.04.016. Epub 2019 May 16.

Abstract

BACKGROUND

Staphylococcus aureus bacteremia (SAB) is associated with significant morbidity and mortality. Previous studies had shown that PET/CT can be helpfull in the management of SAB, leading to reduction of mortality. Factors associated with increased or reduced mortality are not well known. Our objective was to analyze mortality in high risk SAB patients undergoing PET/CT and to identify factors associated with mortality rate.

MATERIALS AND METHODS

We performed a retrospective study and reviewed all cases of high risk adult SAB between 2014 and 2017. We analyzed medical records and mortality at 30 days and 90 days and 1 year.

RESULTS

A total of 102 patients were included in whom 48 undergone PET/CT. Metastatic foci was identified in 45.8% of cases (22/48). The overall mortality rate was 31.4% (32/102). The mortality rate was 16.6% (8/48) and 44.4% (24/54) in patients undergoing or not PET/CT respectively (P = 0.002). There was a signicantly difference in mortality rate at 30 days (P = 0.001), 90 days (P = 0.004) and one at 1 year (P = 0.002) between patients undergoing or not PET/CT respectively. In multivariate analysis only 18-FDGPET/CT, kidney failure and bacteremia of unknown origin were the 3 mains factors modifying mortality in patients with high risk SAB.

CONCLUSION

In our study mortality rate was reduced in high risk SAB patients undergoing PET/CT. kidney failure and bacteremia of unknown origin were other factors associtated with high mortality. Our study confirm that PET/CT is a usefull tool in the management of SAB.

摘要

背景

金黄色葡萄球菌菌血症(SAB)与较高的发病率和死亡率相关。既往研究显示,PET/CT 有助于 SAB 的管理,降低死亡率。但目前尚不清楚哪些因素与死亡率的增加或降低相关。本研究旨在分析行 PET/CT 的高危 SAB 患者的死亡率,并确定与死亡率相关的因素。

材料和方法

我们进行了一项回顾性研究,分析了 2014 年至 2017 年间所有高危成人 SAB 病例。分析了患者的病历资料及 30 天、90 天和 1 年的死亡率。

结果

共纳入 102 例患者,其中 48 例行 PET/CT。45.8%(22/48)的患者发现转移性病灶。总死亡率为 31.4%(32/102)。行 PET/CT 与未行 PET/CT 的患者死亡率分别为 16.6%(8/48)和 44.4%(24/54)(P=0.002)。两组患者的 30 天死亡率(P=0.001)、90 天死亡率(P=0.004)和 1 年死亡率(P=0.002)均有显著差异。多因素分析显示,仅 18F-FDGPET/CT、肾衰竭和不明来源菌血症是高危 SAB 患者死亡率的 3 个主要影响因素。

结论

在本研究中,行 PET/CT 的高危 SAB 患者死亡率降低。肾衰竭和不明来源菌血症是其他高死亡率相关因素。本研究证实,PET/CT 是 SAB 管理的有用工具。

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