Bae Seongman, Kook Min Soo, Chang Euijin, Jung Jiwon, Kim Min Jae, Chong Yong Pil, Kim Sung-Han, Choi Sang-Ho, Lee Sang-Oh, Kim Yang Soo
Division of Infectious Diseases, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Center for Antimicrobial Resistance and Microbial Genetics, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Open Forum Infect Dis. 2025 Jun 25;12(6):ofaf338. doi: 10.1093/ofid/ofaf338. eCollection 2025 Jun.
bacteremia (SAB) is a significant cause of morbidity and mortality, with a high risk of metastatic infections. Understanding the timing and distribution of metastatic infections based on the primary infection focus is crucial for effective management. We aimed to identify patterns that could guide clinicians in prioritizing surveillance and interventions for patients at high risk of metastatic infection.
This retrospective cohort study analyzed 1725 patients diagnosed with SAB. We assessed the incidence and distribution of metastatic infections within the cohort, stratifying the data by the timing postdiagnosis and the primary infection focus.
In the cohort of 1725 patients, 289 (16.7%) experienced a total of 439 metastatic infection events within the 90-day follow-up period. The majority of metastatic infections (approximately 85%) occurred within the first 7 days following diagnosis. The incidence of metastatic infections varied significantly with the primary focus of SAB, being highest in patients with endocarditis at 73.4%. The lung was the most frequent metastatic site (23.7%), followed by bones and joints (16.8%) and the central nervous system (12.3%). The distribution of metastatic sites significantly differed according to the primary infection focus.
Our study findings provide essential insights into the risk and distribution of metastatic infections in patients with SAB, highlighting the critical role of the timing and primary infection focus. These findings enable healthcare professionals to adopt a more proactive and targeted approach to managing patients with SAB.
血流感染（SAB）是发病和死亡的重要原因，具有发生转移性感染的高风险。基于原发性感染灶了解转移性感染的时间和分布对于有效管理至关重要。我们旨在确定能够指导临床医生对有转移性感染高风险患者进行优先监测和干预的模式。
这项回顾性队列研究分析了1725例诊断为SAB的患者。我们评估了队列中转移性感染的发生率和分布情况，按诊断后的时间和原发性感染灶对数据进行分层。
在1725例患者的队列中，289例（16.7%）在90天随访期内共发生439次转移性感染事件。大多数转移性感染（约85%）发生在诊断后的前7天内。转移性感染的发生率因SAB的原发性病灶不同而有显著差异，心内膜炎患者中发生率最高，为73.4%。肺是最常见的转移部位（23.7%），其次是骨骼和关节（16.8%）以及中枢神经系统（12.3%）。转移性感染部位的分布因原发性感染灶不同而有显著差异。
我们的研究结果为SAB患者转移性感染的风险和分布提供了重要见解，突出了时间和原发性感染灶的关键作用。这些发现使医护人员能够采用更积极、有针对性的方法来管理SAB患者。
