<sup>18</sup>F-FDG PET/CT Optimizes Treatment in <i>Staphylococcus Aureus</i> Bacteremia and Is Associated with Reduced Mortality.
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Date
2017-09ICR Author
Author
Berrevoets, MAH
Kouijzer, IJE
Aarntzen, EHJG
Janssen, MJR
De Geus-Oei, L-F
Wertheim, HFL
Kullberg, B-J
Oever, JT
Oyen, WJG
Bleeker-Rovers, CP
Type
Journal Article
Metadata
Show full item recordAbstract
Metastatic infection is an important complication of Staphylococcus aureus bacteremia (SAB). Early diagnosis of metastatic infection is crucial, because specific treatment is required. However, metastatic infection can be asymptomatic and difficult to detect. In this study, we investigated the role of 18 F-FDG PET/CT in patients with SAB for detection of metastatic infection and its consequences for treatment and outcome. Methods: All patients with SAB at Radboud University Medical Center were included between January 2013 and April 2016. Clinical data and results of 18 F-FDG PET/CT and other imaging techniques, including echocardiography, were collected. Primary outcomes were newly diagnosed metastatic infection by 18 F-FDG PET/CT, subsequent treatment modifications, and patient outcome. Results: A total of 184 patients were included, and 18 F-FDG PET/CT was performed in 105 patients, of whom 99 had a high-risk bacteremia. 18 F-FDG PET/CT detected metastatic infectious foci in 73.7% of these high-risk patients. In 71.2% of patients with metastatic infection, no signs and symptoms suggesting metastatic complications were present before 18 F-FDG PET/CT was performed. 18 F-FDG PET/CT led to a total of 104 treatment modifications in 74 patients. Three-month mortality was higher in high-risk bacteremia patients without 18 F-FDG PET/CT performed than in those in whom 18 F-FDG PET/CT was performed (32.7% vs. 12.4%, P = 0.003). In multivariate analysis, 18 F-FDG PET/CT was the only factor independently associated with reduced mortality ( P = 0.005; odds ratio, 0.204; 95% confidence interval, 0.066-0.624). A higher comorbidity score was independently associated with increased mortality ( P = 0.003; odds ratio, 1.254; 95% confidence interval, 1.078-1.457). Conclusion: 18 F-FDG PET/CT is a valuable technique for early detection of metastatic infectious foci, often leading to treatment modification. Performing 18 F-FDG PET/CT is associated with significantly reduced 3-mo mortality.
Collections
Subject
Humans
Staphylococcus aureus
Bacteremia
Staphylococcal Infections
Fluorodeoxyglucose F18
Treatment Outcome
Risk Factors
Retrospective Studies
Adolescent
Adult
Aged
Aged, 80 and over
Middle Aged
Female
Male
Young Adult
Positron Emission Tomography Computed Tomography
Research team
Translational Molecular Imaging
Language
eng
Date accepted
2017-03-13
License start date
2017-09
Citation
Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 2017, 58 (9), pp. 1504 - 1510