Mortality in patients with high risk Staphylococcus aureus bacteremia undergoing or not PET-CT: A single center experience

J Infect Chemother. 2019 Nov;25(11):880-885. doi: 10.1016/j.jiac.2019.04.016. Epub 2019 May 16.

Abstract

Background: Staphylococcus aureus bacteremia (SAB) is associated with significant morbidity and mortality. Previous studies had shown that PET/CT can be helpfull in the management of SAB, leading to reduction of mortality. Factors associated with increased or reduced mortality are not well known. Our objective was to analyze mortality in high risk SAB patients undergoing PET/CT and to identify factors associated with mortality rate.

Materials and methods: We performed a retrospective study and reviewed all cases of high risk adult SAB between 2014 and 2017. We analyzed medical records and mortality at 30 days and 90 days and 1 year.

Results: A total of 102 patients were included in whom 48 undergone PET/CT. Metastatic foci was identified in 45.8% of cases (22/48). The overall mortality rate was 31.4% (32/102). The mortality rate was 16.6% (8/48) and 44.4% (24/54) in patients undergoing or not PET/CT respectively (P = 0.002). There was a signicantly difference in mortality rate at 30 days (P = 0.001), 90 days (P = 0.004) and one at 1 year (P = 0.002) between patients undergoing or not PET/CT respectively. In multivariate analysis only 18-FDGPET/CT, kidney failure and bacteremia of unknown origin were the 3 mains factors modifying mortality in patients with high risk SAB.

Conclusion: In our study mortality rate was reduced in high risk SAB patients undergoing PET/CT. kidney failure and bacteremia of unknown origin were other factors associtated with high mortality. Our study confirm that PET/CT is a usefull tool in the management of SAB.

Keywords: 18F-FDG PET/CT; Bacteremia; Mortality; Staphylococcus aureus.

MeSH terms

  • Aged
  • Bacteremia / microbiology
  • Bacteremia / mortality*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Positron Emission Tomography Computed Tomography / methods
  • Retrospective Studies
  • Risk Factors
  • Staphylococcal Infections / microbiology
  • Staphylococcal Infections / mortality*
  • Staphylococcus aureus / pathogenicity*