Comparing Echocardiography to No Echocardiography in Adults with Staphylococcus Aureus Bloodstream Infection and Low VIRSTA Score

What this Trial Is About

Staphylococcus aureus bloodstream infections are a common and serious health concern worldwide, with infective endocarditis IE complicating 5-17% of these cases and leading to worse outcomes. Researchers have developed the VIRSTA score to identify patients with low risk of IE, aiming to reduce unnecessary echocardiography. This trial evaluates whether skipping echocardiography in patients with a VIRSTA score under 3 affects mortality and relapse of infection. Participants are randomly assigned to one of two groups one group will receive systematic echocardiography, including transthoracic and possibly transoesophageal echocardiography within 14 days of diagnosis, while the other group will not have echocardiography unless new signs suggestive of IE appear. Both groups will receive standard antibiotic treatment adjusted based on echocardiography results in the control group. The study focuses on outcomes measured at 90 days after diagnosis. During the study, participants will be monitored for death and relapse of Staphylococcus aureus bacteremia. Additional assessments include detection of definite IE, need for heart valve surgery, hospital stay length, quality of life, and healthcare costs up to 180 days. The study includes careful follow-up to capture any delayed diagnosis or complications related to IE, ensuring comprehensive evaluation of patient outcomes.

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