Verdejo Miguel Ángel, Perissinotti Andrés, Malano-Barletta Daniela, Pitart Cristina, Cuervo Guillermo, Hernández-Meneses Marta, Bodro Marta, Herrera Sabina, García-Vidal Carolina, Puerta-Alcalde Pedro, Martínez José Antonio, Del Río Ana, Espasa Mateu, Fuster David, Morata Laura, Soriano Alex
Department of Infectious Diseases, Hospital Clínic Barcelona, University of Barcelona, Barcelona, Spain.
Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain.
BMC Infect Dis. 2025 May 7;25(1):671. doi: 10.1186/s12879-025-11055-6.
To evaluate the detection rate of septic metastases in catheter-related S. aureus bacteremia (CR-SAB) episodes by using [18F]FDG-PET/CT.
We conducted a retrospective, before-and-after, single-center study of a prospectively identified catheter-related SAB (CR-SAB) cohort at Hospital Clínic Barcelona. All adult patients hospitalized from January 2006 to December 2022 were included. Primary outcome was the detection of septic metastases before and after integrating [18F]FDG-PET/CT into the diagnostic workflow of CR-SAB in January 2020. Secondary outcomes included 30-day mortality, length of stay, and treatment duration.
A total of 598 episodes of CR-SAB were included, 100 in the post-intervention period (2020-2022) and 498 in the pre-intervention period (2006-2019). [18F]FDG-PET/CT scan was performed in 28/100 episodes (28.0%) in post-intervention period, versus 9/498 in pre-intervention period (1.8%). Septic metastases detection rate was higher after [18F]FDG-PET/CT implementation (22/100, 22% vs. 56/498, 11.2% p .004), mainly due to pulmonary septic emboli (13/100, 13.0% vs. 12/498, 2.4% p < .001) and osteoarticular seeding (7/100, 7.0% vs. 11/498, 2.2% p .019). Neither pulmonary septic emboli nor osteoarticular metastases increased 30-day mortality (3/25, 12.0% vs. 57/573, 10.0%, p .732; and 2/18, 11.1% vs. 58/580 10.0%, p .702, respectively). Patients with septic metastases had longer treatment [25.0 (16.0-37.0) vs. 15.0 (13.0-19.0) days, p < .001].
[18F]FDG-PET/CT use in patients with CR-SAB was associated with a higher rate of septic metastases diagnosis, mainly pulmonary and osteoarticular, resulting in longer treatment, but no differences in clinical outcomes were observed.
通过使用[18F]FDG-PET/CT评估导管相关金黄色葡萄球菌菌血症（CR-SAB）发作中感染性转移灶的检出率。
我们在巴塞罗那临床医院对一个前瞻性确定的导管相关SAB（CR-SAB）队列进行了一项回顾性、前后对照的单中心研究。纳入了2006年1月至2022年12月期间住院的所有成年患者。主要结局是在2020年1月将[18F]FDG-PET/CT纳入CR-SAB诊断流程前后感染性转移灶的检出情况。次要结局包括30天死亡率、住院时间和治疗持续时间。
共纳入598例CR-SAB发作，干预后期（2020 - 2022年）100例，干预前期（2006 - 2019年）498例。干预后期28/100例（28.0%）进行了[18F]FDG-PET/CT扫描，而干预前期为9/498例（1.8%）。[18F]FDG-PET/CT实施后感染性转移灶检出率更高（22/100，22% vs. 56/498，11.2%，p = 0.004），主要归因于肺感染性栓子（13/100，13.0% vs. 12/498，2.4%，p < 0.001）和骨关节炎播散（7/100，7.0% vs. 11/498，2.2%，p = 0.019）。肺感染性栓子和骨关节炎转移灶均未增加30天死亡率（分别为3/25，12.0% vs. 57/573，10.0%，p = 0.732；以及2/18，11.1% vs. 58/580，10.0%，p = 0.702）。有感染性转移灶的患者治疗时间更长[25.0（16.0 - 37.0）天 vs. 15.0（13.0 - 19.0）天，p < 0.001]。
CR-SAB患者使用[18F]FDG-PET/CT与更高的感染性转移灶诊断率相关，主要是肺部和骨关节炎性的，导致治疗时间更长，但未观察到临床结局的差异。
