دورية أكاديمية
Low-Risk Staphylococcus aureus Bacteremia Patients Do Not Require Routine Diagnostic Imaging: A Multicenter, Retrospective, Cohort Study.
العنوان: | Low-Risk Staphylococcus aureus Bacteremia Patients Do Not Require Routine Diagnostic Imaging: A Multicenter, Retrospective, Cohort Study. |
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المؤلفون: | Hendriks MMC; Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands., Schweren KSA; Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands., Kleij A; Department of Internal Medicine, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands., Berrevoets MAH; Department of Internal Medicine, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands., de Jong E; Department of Internal Medicine, Amphia Hospital, Breda, The Netherlands., van Wijngaarden P; Department of Internal Medicine, Amphia Hospital, Breda, The Netherlands., Ammerlaan HSM; Department of Internal Medicine, Catharina Hospital, Eindhoven, The Netherlands., Vos A; Department of Internal Medicine, Treant, Emmen, The Netherlands., van Assen S; Department of Internal Medicine, Treant, Emmen, The Netherlands., Slieker K; Department of Internal Medicine, Bernhoven Hospital, Uden, The Netherlands., Gisolf JH; Department of Intenal Medicine, Rijnstate Hospital, Arnhem, The Netherlands., Netea MG; Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands.; Department of Immunology and Metabolism, Life and Medical Sciences Institute, University of Bonn, Bonn, Germany., Ten Oever J; Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands., Kouijzer IJE; Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands. |
المصدر: | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2024 Jul 19; Vol. 79 (1), pp. 43-51. |
نوع المنشور: | Journal Article; Multicenter Study |
اللغة: | English |
بيانات الدورية: | Publisher: Oxford University Press Country of Publication: United States NLM ID: 9203213 Publication Model: Print Cited Medium: Internet ISSN: 1537-6591 (Electronic) Linking ISSN: 10584838 NLM ISO Abbreviation: Clin Infect Dis Subsets: MEDLINE |
أسماء مطبوعة: | Publication: Jan. 2011- : Oxford : Oxford University Press Original Publication: Chicago, IL : The University of Chicago Press, c1992- |
مواضيع طبية MeSH: | Staphylococcal Infections*/microbiology , Staphylococcal Infections*/diagnosis , Bacteremia*/microbiology , Bacteremia*/diagnosis , Bacteremia*/drug therapy , Staphylococcus aureus*/isolation & purification, Humans ; Retrospective Studies ; Male ; Female ; Middle Aged ; Aged ; Netherlands/epidemiology ; Diagnostic Imaging/methods ; Adult ; Cross Infection/microbiology |
مستخلص: | Background: Stratification to categorize patients with Staphylococcus aureus bacteremia (SAB) as low or high risk for metastatic infection may direct diagnostic evaluation and enable personalized management. We investigated the frequency of metastatic infections in low-risk SAB patients, their clinical relevance, and whether omission of routine imaging is associated with worse outcomes. Methods: We performed a retrospective cohort study at 7 Dutch hospitals among adult patients with low-risk SAB, defined as hospital-acquired infection without treatment delay, absence of prosthetic material, short duration of bacteremia, and rapid defervescence. Primary outcome was the proportion of patients whose treatment plan changed due to detected metastatic infections, as evaluated by both actual therapy administered and by linking a adjudicated diagnosis to guideline-recommended treatment. Secondary outcomes were 90-day relapse-free survival and factors associated with the performance of diagnostic imaging. Results: Of 377 patients included, 298 (79%) underwent diagnostic imaging. In 15 of these 298 patients (5.0%), imaging findings during patient admission had been interpreted as metastatic infections that should extend treatment. Using the final adjudicated diagnosis, 4 patients (1.3%) had clinically relevant metastatic infection. In a multilevel multivariable logistic regression analysis, 90-day relapse-free survival was similar between patients without imaging and those who underwent imaging (81.0% versus 83.6%; adjusted odds ratio, 0.749; 95% confidence interval, .373-1.504). Conclusions: Our study advocates risk stratification for the management of SAB patients. Prerequisites are follow-up blood cultures, bedside infectious diseases consultation, and a critical review of disease evolution. Using this approach, routine imaging could be omitted in low-risk patients. Competing Interests: Potential conflicts of interest. The authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.) |
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فهرسة مساهمة: | Keywords: Staphylococcus aureus; bacteremia; diagnostics; low risk; risk stratification |
تواريخ الأحداث: | Date Created: 20240405 Date Completed: 20240719 Latest Revision: 20240721 |
رمز التحديث: | 20240721 |
مُعرف محوري في PubMed: | PMC11259217 |
DOI: | 10.1093/cid/ciae187 |
PMID: | 38576380 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1537-6591 |
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DOI: | 10.1093/cid/ciae187 |