Echocardiography Versus no Echocardiography in S. Aureus Bacteraemia and VIRSTA Score < 3

ConditionsStaphylococcus Aureus Bacteremia Infective Endocarditis

Trial statusRecruiting

Trial phaseNot applicable

Trial typeInterventional

Biological sexAll

Age18+

SponsorAssistance Publique - Hôpitaux de Paris

About this trial

Staphylococcus aureus is the most frequent cause of both healthcare-associated and community-acquired bloodstream infections worldwide. Infective endocarditis (IE) has been detected in 5-17% of cases and is a determinant of poor prognosis. The investigators developed a score (the VIRSTA score) based on patients' characteristics to rule out IE with high confidence (negative predictive value (NPV) above 99%) in patients with SAB. This score, with a cut-off of 3 has been externally validated by two international studies which have also established its high NPV. The 2023 European society of cardiology (ESC) guidelines state that echocardiography should be considered in all patients with Staphylococcus aureus bacteremia (SAB) using risk scores (including VIRSTA score) to guide the use or not of echocardiography. While recommended, the investigators think that VIRSTA score must be evaluated in terms of patients' outcome.

Eligibility criteria

Qualifiers

Volunteers over 18 years of age;

Hospitalized with at least one blood culture positive for Staphylococcus aureus;

At the time of inclusion, negative control blood culture performed 48 hours after the first Staphylococcus aureus blood culture collection;

VIRSTA score < 3;

Disqualifiers

Patient with catheter colonization without SAB, defined as positive blood cultures only through vascular access device specimen;

Patient referred to the hospital for the management of IE;

Contra indication to transthoracic echocardiography (TTE);

Echocardiography already performed before inclusion (TTE or TEE) for the current SAB;

Trial design

Treatments tested in this trial

systematic echocardiography
no echocardiography arm

Treatment groups

700 Participants

are divided into 2 treatment groups

Sponsors and collaborators

Assistance Publique - Hôpitaux de Paris

Lead sponsor

Source ClinicalTrials.gov