Rationalising heterogeneity in Staphylococcus aureus bacteraemia: current progress and future goals

Area of Science:

• Infectious Diseases
• Clinical Microbiology
• Medical Informatics

Background:

• Staphylococcus aureus bacteraemia (SAB) presents significant clinical and biological heterogeneity.
• Treating SAB as a monolithic entity impedes the development of effective therapeutic strategies.

Purpose of the Study:

• To review and compare recent data-driven patient stratification approaches for SAB.
• To discuss the limitations of current methods and propose future research directions.
• To highlight the importance of addressing heterogeneity for advancing SAB management.

Main Methods:

• Comparison of methodologies from three recent studies (Swets et al, FEN-AUREUS, MRSA-GEIRAS-SEIMC) utilizing routinely available data for SAB patient stratification.
• Analysis of findings related to mortality, microbiologic outcomes, and response to adjunctive therapies.

Main Results:

• Three distinct data-driven approaches identified clinically relevant SAB subphenotypes.
• These subphenotypes exhibit variations in mortality, treatment response, and microbiological outcomes.
• The studies underscore the potential of patient stratification in optimizing SAB management.

Conclusions:

• Addressing clinical and biological heterogeneity in SAB is crucial for transformative advances.
• Progress requires moving from observable clinical subphenotypes to mechanism-based endotypes.
• Future research should focus on refining stratification methods and identifying treatable traits.