[18F]FDG-PET/CT in Staphylococcus aureus bacteremia: a systematic review

Area of Science:

• Nuclear medicine imaging
• Infectious disease diagnostics
• Systematic review methodology

Background:

• [18F]FDG-PET/CT is utilized for diagnosing metastatic infections in Staphylococcus aureus bacteremia (SAB).
• The impact of [18F]FDG-PET/CT on patient outcomes in SAB is not well-established.
• Antibiotic treatment guidance is a key application of [18F]FDG-PET/CT in SAB management.

Purpose of the Study:

• To systematically review the effects of [18F]FDG-PET/CT on all-cause mortality in SAB patients.
• To evaluate the impact of [18F]FDG-PET/CT on new diagnostic findings in SAB.
• To synthesize current evidence on the clinical utility of [18F]FDG-PET/CT for SAB.

Main Methods:

• Systematic search of major scientific databases (PubMed, EMBASE, Web of Science, Cochrane Library) up to January 29, 2021.
• Inclusion of randomized controlled trials, cohort studies, and case-control studies involving adult SAB patients.
• Assessment of risk of bias using ROBINS-I and certainty of evidence using GRADE by two independent reviewers.

Main Results:

• Five studies with 880 SAB patients were included; all were non-randomized with moderate to serious risk of bias.
• Four studies (804 patients) indicated lower mortality rates in SAB patients who underwent [18F]FDG-PET/CT.
• One study (102 patients) reported an increased detection of metastatic foci with [18F]FDG-PET/CT.

Conclusions:

• Evidence suggests a potential reduction in mortality for SAB patients receiving [18F]FDG-PET/CT, though certainty is low.
• Improved outcomes may be attributed to enhanced guidance for antibiotic therapy and source control interventions.
• [18F]FDG-PET/CT may play a role in optimizing management strategies for Staphylococcus aureus bacteremia.