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-FDG PET/CT and MRI (including whole-body MRI, WB-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.

中文翻译：

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成像在金黄色葡萄球菌菌血症的调查和管理中：先进成像技术的作用。


金黄色葡萄球菌菌血症 (SAB) 每年继续影响英国约 25,000 名患者，90 天的粗死亡率高达 30%。及时的源头控制可改善脓毒症和 SAB 的预后，并已纳入脓毒症指南中。最近一项针对 SAB 抗生素辅助治疗的临床试验发现，大多数 SAB 复发与源头管理失败有关。在这种情况下，控制感染源的能力可能会受到检测感染灶的能力的限制。超声心动图现在是一种常规使用的工具，用于检测这种意想不到的传染性植被形式的未知病灶。我们回顾文献，探索先进成像技术的实用性，例如 18F-FDG PET/CT 和 MRI（包括全身 MRI、WB-MRI），以检测可能被遗漏的病灶。由于未知病灶与死亡率增加相关，我们建议增加病灶检测可以改善源头控制并改善 SAB 的结果。