Norberhuis, C. BSc (2024) Skip Phenomenon in Staphylococcus aureus Bacteremia associated with High Mortality and High Incidence of Metastatic Complications: Clinical Implications. thesis, Medicine.
Full text available on request.Abstract
Background: Staphylococcus aureus is a common cause of bacteremia (SAB). SAB is associated with a high incidence of metastatic complications and high mortality. Persistent bacteremia is associated with even higher incidence of complications and mortality. Blood cultures (BCs) are the gold standard in SAB diagnostics. BCs can be intermittently negative in SAB, potentially leading to incorrect notion of SAB clearance. Literature regarding this skip phenomenon (SP) is scarce. To this day, no studies have directly compared SP to both persistent and non-persistent bacteremia. Method: In this retrospective cohort study 314 patients with SAB were divided into SP, persistent bacteremia (without SP) and non-persistent bacteremia groups. Patient characteristics, incidence of metastatic complications and mortality were compared between groups. Risk factors for SP occurrence were assessed. Results: 23 cases of SP were observed (7.3% of study population). SP was associated with higher mortality and with increased metastatic complications compared to non-persistent bacteremia. SP was comparable to persistent bacteremia regarding metastatic complications, mortality and risk factors. Conclusion: Intermittent negative blood cultures are not uncommon in SAB and the concept of SP as a clinical entity should be taken into account by clinicians. SP is associated with increased risk of metastatic complications and mortality, comparable to that of patients with persistent bacteremia without SP. Occurrence of SP requires further diagnostic work-up into metastatic complications. In order to document a patient as having cleared SAB at least two negative follow-up BCs, consisting of two sets each, taken 48 hours apart should be obtained.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Assen, dr. S. van and Vos, A. |
| Faculty: | Medical Sciences |
| Date Deposited: | 29 Sep 2025 13:20 |
| Last Modified: | 29 Sep 2025 13:20 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3828 |
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