Clinical Subphenotypes of Staphylococcus aureus Bacteremia Article Swipe
Maaike Swets
,
Zsuzsa Bakk
,
Annette C. Westgeest
,
Karla Berry
,
George Cooper
,
Wynne Sim
,
Rui Shian Lee
,
Tze Yi Gan
,
William C. Donlon
,
Antonia Besu
,
Emily Heppenstall
,
Luke Tysall
,
Simon Dewar
,
Mark de Boer
,
Vance G. Fowler
,
David H. Dockrell
,
Guy Thwaites
,
Miquel Pujol
,
Natàlia Pallarès
,
Cristian Tebé
,
Jordi Carratalà
,
Alexander J. Szubert
,
Geert H. Groeneveld
,
Clark D Russell
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1093/cid/ciae338
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1093/cid/ciae338
Background Staphylococcus aureus bacteremia (SAB) is a clinically heterogeneous disease. The ability to identify subgroups of patients with shared traits (subphenotypes) is an unmet need to allow patient stratification for clinical management and research. We aimed to test the hypothesis that clinically relevant subphenotypes can be reproducibly identified among patients with SAB. Methods We studied 3 cohorts of adults with monomicrobial SAB: a UK retrospective observational study (Edinburgh cohort, n = 458), the UK ARREST trial (n = 758), and the Spanish SAFO trial (n = 214). Latent class analysis was used to identify subphenotypes using routinely collected clinical data without considering outcomes. Mortality and microbiologic outcomes were then compared between subphenotypes. Results Included patients had predominantly methicillin-susceptible SAB (1366 of 1430, 95.5%). We identified 5 distinct, reproducible clinical subphenotypes: (A) SAB associated with older age and comorbidity, (B) nosocomial intravenous catheter-associated SAB in younger people without comorbidity, (C) community-acquired metastatic SAB, (D) SAB associated with chronic kidney disease, and (E) SAB associated with injection drug use. Survival and microbiologic outcomes differed between the subphenotypes. Mortality was highest in subphenotype A and lowest in subphenotypes B and E. Microbiologic outcomes were worse in subphenotype C. In a secondary analysis of the ARREST trial, adjunctive rifampicin was associated with increased mortality in subphenotype B and improved microbiologic outcomes in subphenotype C. Conclusions We have identified reproducible and clinically relevant subphenotypes within SAB and provide proof of principle of differential treatment effects. Through clinical trial enrichment and patient stratification, these subphenotypes could contribute to a personalized medicine approach to SAB.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1093/cid/ciae338
- https://academic.oup.com/cid/advance-article-pdf/doi/10.1093/cid/ciae338/58327711/ciae338.pdf
- OA Status
- hybrid
- Cited By
- 13
- References
- 32
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4400000929
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W4400000929Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1093/cid/ciae338Digital Object Identifier
- Title
-
Clinical Subphenotypes of Staphylococcus aureus BacteremiaWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2024Year of publication
- Publication date
-
2024-06-25Full publication date if available
- Authors
-
Maaike Swets, Zsuzsa Bakk, Annette C. Westgeest, Karla Berry, George Cooper, Wynne Sim, Rui Shian Lee, Tze Yi Gan, William C. Donlon, Antonia Besu, Emily Heppenstall, Luke Tysall, Simon Dewar, Mark de Boer, Vance G. Fowler, David H. Dockrell, Guy Thwaites, Miquel Pujol, Natàlia Pallarès, Cristian Tebé, Jordi Carratalà, Alexander J. Szubert, Geert H. Groeneveld, Clark D RussellList of authors in order
- Landing page
-
https://doi.org/10.1093/cid/ciae338Publisher landing page
- PDF URL
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https://academic.oup.com/cid/advance-article-pdf/doi/10.1093/cid/ciae338/58327711/ciae338.pdfDirect link to full text PDF
- Open access
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YesWhether a free full text is available
- OA status
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hybridOpen access status per OpenAlex
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https://academic.oup.com/cid/advance-article-pdf/doi/10.1093/cid/ciae338/58327711/ciae338.pdfDirect OA link when available
- Concepts
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Medicine, Comorbidity, Phenotype, Internal medicine, Observational study, Retrospective cohort study, Biology, Gene, BiochemistryTop concepts (fields/topics) attached by OpenAlex
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-
13Total citation count in OpenAlex
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2025: 10, 2024: 3Per-year citation counts (last 5 years)
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32Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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