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Imaging in the investigation and management of Staphylococcus aureus bacteraemia: A role for advanced imaging techniques

Research output: Contribution to journalReview article

Anna L Goodman, Gary J Cook, Vicky Goh

Original languageEnglish
Pages (from-to)234-241
Number of pages8
JournalJournal of Hospital Infection
Volume105
Issue number2
Early online date14 Jan 2020
DOIs
E-pub ahead of print14 Jan 2020
PublishedJun 2020

Bibliographical note

Copyright © 2020. Published by Elsevier Ltd.

King's Authors

Abstract

Staphylococcus aureus bacteraemia (SAB) continues to affect ∼25,000 patients in the UK per year with a high crude mortality of 30% at 90 days. Prompt source control improves outcomes in sepsis and SAB and is included in sepsis guidelines. A recent clinical trial of adjunctive antibiotic treatment in SAB found that the majority of recurrences of SAB were associated with a failure of source management. In this condition, the ability to control the source of infection may be limited by the ability to detect a focus of infection. Echocardiogram is now a routinely used tool to detect such unknown foci in the form of unexpected infectious vegetations. We review the literature to explore the utility of advanced imaging techniques, such as [18F]fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and magnetic resonance imaging (including whole-body MRI), to detect foci which may otherwise be missed. As unknown foci are associated with increased mortality, we propose that increasing the detection of foci could enable improved source control and result in improved outcomes in SAB.

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