Host response signature trends in persistent bacteraemia and metastatic infection due to Staphylococcus aureus and Gram-negative bacilli: a prospective multicentre observational study
Rattachement africain : au, sg. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Background A prompt diagnosis of bacteraemia and sepsis is essential. Markers to predict the risk of persistent bacteraemia and metastatic infection are lacking. SeptiCyte RAPID is a host response assay stratifying patients according to the risk of infectious vs sterile inflammation through a scoring system (SeptiScore). In this study we explore the association between SeptiScore and persistent bacteraemia as well as metastatic and persistent infection in the context of a proven bacteraemia episode.Methods This is a prospective multicentre observational 14-month study on patients with proven bacteraemia caused by Staphylococcus aureus or Gram-negative bacilli. Samples for assessment by SeptiCyte were collected with paired blood cultures for 4 consecutive days after the index blood culture.Results We included 86 patients in the study, 40 with S. aureus and 46 with Gram-negative bacilli bacteraemia. SeptiScores over the follow-up were higher in patients with Gram-negative compared to S. aureus bacteraemia (median 6.4, IQR 5.5–7.4 vs 5.6 IQR 5.1–6.2, p = 0.002). Higher SeptiScores were found to be associated with positive blood cultures at follow-up (AUC = 0.86, 95%CI 0.68–1.00) and with a diagnosis of metastatic infection at day 1 and 2 of follow-up (AUC = 0.79, 95%CI 0.57–1.00 and AUC = 0.82, 95%CI 0.63–1.00 respectively) in the context of Gram-negative bacteraemia while no association between SeptiScore and the outcomes of interest was observed in S. aureus bacteraemia. Mixed models confirmed the association of SeptiScore with positive blood cultures at follow-up (p = 0.04) and metastatic infection (p = 0.03) in the context of Gram-negative bacteraemia but not S. aureus bacteraemia after adjusting for confounders.Conclusions SeptiScores differ in the follow-up of S. aureus and Gram-negative bacteraemia. In the setting of Gram-negative bacteraemia SeptiScore demonstrated a good negative predictive value for the outcomes of interest and might help rule out the persistence of infection defined as metastatic spread, lack of source control or persistent bacteraemia.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé, mais le titre doit être comparé manuellement.
- Titre Crossref
- Host response signature trends in persistent bacteraemia and metastatic infection due to <i>Staphylococcus aureus</i> and Gram-negative bacilli: a prospective multicentre observational study
- Date Crossref
- 13/12/2023
- Éditeur
- Informa UK Limited
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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The University of Queensland pays non établi dans la noticeUniversité ou école supérieure
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Redcliffe Hospital Infectious Diseases Unit pays non établi dans la noticeÉtablissement de santé
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Royal Brisbane and Women's Hospital Infectious Diseases Unit pays non établi dans la noticeÉtablissement de santé
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Queensland University of Technology pays non établi dans la noticeUniversité ou école supérieure
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National University of Singapore pays non établi dans la noticeUniversité ou école supérieure
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National University Health System pays non établi dans la noticeUniversité ou école supérieure
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Caboolture Hospital Infectious Diseases Unit pays non établi dans la noticeÉtablissement de santé
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Herston Infectious Diseases Institute pays non établi dans la noticeStructure de recherche
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Faculty of Medicine pays non établi dans la noticeUniversité ou école supérieure
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Saw Swee Hock School of Public Health ADVANCE-ID pays non établi dans la noticeUniversité ou école supérieure
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Yong Loo Lin School of Medicine Infectious Diseases Translational Research Programme pays non établi dans la noticeUniversité ou école supérieure
The University of Queensland, Infectious Diseases Unit — Redcliffe Hospital et Infectious Diseases Unit — Royal Brisbane and Women's Hospital, avec 8 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.