Department of Internal Medicine and Infectious Diseases, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, 10 av Hippocrate, 1200 Brussels, Belgium.
Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, 10 av Hippocrate, 1200 Brussels, Belgium.
Infect Dis Now. 2024 Oct;54(7):104977. doi: 10.1016/j.idnow.2024.104977. Epub 2024 Sep 12.
Staphylococcus aureus bacteremia (SAB) is a leading cause of community and hospital-acquired bacteremia with significant morbidity and mortality. Effective management depends on accurate diagnosis, source control and assessment of metastatic infections. [F] FDG PET/CT has been shown to reduce mortality in high-risk SAB patients. This study aims to evaluate the impact of [F] FDG PET/CT on outcomes in patients with SAB.
Single-center, retrospective, real-life setting study including all consecutive SAB cases from 2017 to 2019. Medical records were analyzed to collect information.
Out of the 315 included patients, 132 underwent [F] FDG PET/CT. In those patients, a clear focus of infection was more frequently identified, leading to better adapted treatments and extended hospital stays. Overall mortality rates at 30 days, 90 days and one year were 25.1 %, 36.8 % and 44.8 % respectively. Mortality was significantly lower in the [F] FDG PET/CT group (p < 0.0001) and persisted (p < 0.05) after adjusting for imbalances between groups regarding oncologic patients and deaths within 7 days. The difference in mortality remained significant irrespective of prolonged bacteremia but was not significant with regard to hospital-acquired SAB. Supplementary analysis using the Cox proportional hazards model confirmed that [F] FDG PET/CT was significantly associated with reduced mortality (p < 0.05).
In this real-life cohort, patients with SAB having undergone [F] FDG PET/CT experienced lower mortality rates, highlighting the additional value of [F] FDG PET/CT in SAB management. Further research is needed to identify the subpopulations that would benefit most from the integration of [F] FDG PET/CT in their work-up.
金黄色葡萄球菌菌血症（SAB）是社区和医院获得性菌血症的主要原因，具有较高的发病率和死亡率。有效的管理取决于准确的诊断、源头控制和转移性感染的评估。[F]FDG PET/CT 已被证明可降低高危 SAB 患者的死亡率。本研究旨在评估[F]FDG PET/CT 对 SAB 患者结局的影响。
这是一项单中心、回顾性、真实世界的研究，纳入了 2017 年至 2019 年所有连续的 SAB 病例。分析病历以收集信息。
在纳入的 315 例患者中，有 132 例行[F]FDG PET/CT。在这些患者中，更频繁地发现明确的感染病灶，从而使治疗更具针对性，并延长了住院时间。30 天、90 天和 1 年的总死亡率分别为 25.1%、36.8%和 44.8%。[F]FDG PET/CT 组的死亡率显著降低（p<0.0001），且在调整了肿瘤患者和 7 天内死亡的组间差异后仍具有统计学意义（p<0.05）。死亡率的差异在延长菌血症的情况下仍然显著，但在医院获得性 SAB 中则不显著。使用 Cox 比例风险模型进行的补充分析证实，[F]FDG PET/CT 与降低死亡率显著相关（p<0.05）。
在本真实世界队列中，行[F]FDG PET/CT 的 SAB 患者死亡率较低，这突出了[F]FDG PET/CT 在 SAB 管理中的附加价值。需要进一步研究以确定从[F]FDG PET/CT 整合中获益最多的亚人群。
