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. |
|---|---|
| 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.) |
| References: | Clin Microbiol Infect. 2023 Apr;29(4):498-505. (PMID: 36283610) Clin Infect Dis. 2009 May 15;48 Suppl 4:S260-70. (PMID: 19374582) Lancet Infect Dis. 2024 May;24(5):523-534. (PMID: 38244557) JAMA. 2018 Sep 25;320(12):1249-1258. (PMID: 30264119) Arch Intern Med. 2003 Sep 22;163(17):2066-72. (PMID: 14504120) Contemp Clin Trials. 2012 Sep;33(5):869-80. (PMID: 22627076) Medicine (Baltimore). 2009 Sep;88(5):263-267. (PMID: 19745684) J Nucl Med. 2010 Aug;51(8):1234-40. (PMID: 20660384) Am J Med. 1999 Sep;107(3):198-208. (PMID: 10492311) Eur Heart J. 2015 Nov 21;36(44):3075-3128. (PMID: 26320109) Neth J Med. 2018 Sep;76(7):322-329. (PMID: 30220657) Clin Microbiol Infect. 2022 Jul;28(7):1026.e7-1026.e11. (PMID: 35358683) Clin Infect Dis. 2013 Feb;56(4):527-35. (PMID: 23087397) Eur J Clin Microbiol Infect Dis. 2018 Jun;37(6):1187-1193. (PMID: 29671174) Medicine (Baltimore). 2021 May 7;100(18):e25679. (PMID: 33950948) Int J Clin Pract. 2020 Nov;74(11):e13601. (PMID: 32603544) JAMA Netw Open. 2020 Apr 1;3(4):e202401. (PMID: 32271391) Medicine (Baltimore). 2013 May;92(3):182-188. (PMID: 23619238) J Antimicrob Chemother. 2022 Jun 29;77(7):2003-2010. (PMID: 35425988) Clin Microbiol Infect. 2017 Dec;23(12):900-906. (PMID: 28487168) Clin Infect Dis. 2022 Apr 28;74(8):1442-1449. (PMID: 34272564) Clin Infect Dis. 2011 Feb 1;52(3):285-92. (PMID: 21217178) Clin Infect Dis. 2023 Jul 5;77(1):9-15. (PMID: 36869816) J Infect. 2023 Jan;86(1):9-13. (PMID: 36370898) J Chronic Dis. 1987;40(5):373-83. (PMID: 3558716) Clin Infect Dis. 2021 Dec 6;73(11):e3859-e3866. (PMID: 32639560) Open Forum Infect Dis. 2022 Nov 30;9(12):ofac653. (PMID: 36589483) Circulation. 2015 Oct 13;132(15):1435-86. (PMID: 26373316) Eur J Clin Microbiol Infect Dis. 2016 Jan;35(1):49-55. (PMID: 26490139) J Infect. 2009 Oct;59(4):232-9. (PMID: 19654021) Lancet Infect Dis. 2020 Dec;20(12):1409-1417. (PMID: 32763194) |
| 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 |
Full Text Finder | تدمد: | 1537-6591 |
|---|---|
| DOI: | 10.1093/cid/ciae187 |