Sébastien Briol, Olivier Gheysens, François Jamar, Halil Yildiz, Julien De Greef, Jean Cyr Yombi, Alexia Verroken, Leïla Belkhir
{"title":"Impact of [<sup>18</sup>F] FDG PET/CT on outcomes in patients with Staphylococcus aureus bacteremia: A retrospective single-center experience.","authors":"Sébastien Briol, Olivier Gheysens, François Jamar, Halil Yildiz, Julien De Greef, Jean Cyr Yombi, Alexia Verroken, Leïla Belkhir","doi":"10.1016/j.idnow.2024.104977","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>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. [<sup>18</sup>F] FDG PET/CT has been shown to reduce mortality in high-risk SAB patients. This study aims to evaluate the impact of [<sup>18</sup>F] FDG PET/CT on outcomes in patients with SAB.</p><p><strong>Methods: </strong>Single-center, retrospective, real-life setting study including all consecutive SAB cases from 2017 to 2019. Medical records were analyzed to collect information.</p><p><strong>Results: </strong>Out of the 315 included patients, 132 underwent [<sup>18</sup>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 [<sup>18</sup>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 [<sup>18</sup>F] FDG PET/CT was significantly associated with reduced mortality (p < 0.05).</p><p><strong>Conclusion: </strong>In this real-life cohort, patients with SAB having undergone [<sup>18</sup>F] FDG PET/CT experienced lower mortality rates, highlighting the additional value of [<sup>18</sup>F] FDG PET/CT in SAB management. Further research is needed to identify the subpopulations that would benefit most from the integration of [<sup>18</sup>F] FDG PET/CT in their work-up.</p>","PeriodicalId":13539,"journal":{"name":"Infectious diseases now","volume":null,"pages":null},"PeriodicalIF":2.9000,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infectious diseases now","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.idnow.2024.104977","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: 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. [18F] FDG PET/CT has been shown to reduce mortality in high-risk SAB patients. This study aims to evaluate the impact of [18F] FDG PET/CT on outcomes in patients with SAB.
Methods: Single-center, retrospective, real-life setting study including all consecutive SAB cases from 2017 to 2019. Medical records were analyzed to collect information.
Results: Out of the 315 included patients, 132 underwent [18F] 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 [18F] 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 [18F] FDG PET/CT was significantly associated with reduced mortality (p < 0.05).
Conclusion: In this real-life cohort, patients with SAB having undergone [18F] FDG PET/CT experienced lower mortality rates, highlighting the additional value of [18F] FDG PET/CT in SAB management. Further research is needed to identify the subpopulations that would benefit most from the integration of [18F] FDG PET/CT in their work-up.