SNAPStrat: Patient stratification using SAB subphenotypes
Staphylococcus aureus bacteraemia (SAB) is a clinically heterogeneous disease. The ability to identify sub-groups of patients with shared traits (subphenotypes) is an unmet need to allow patient stratification for clinical management and research. We have reproducibly identified distinct SAB subphenotypes using routinely collected clinical data (Swets et al, Clin Infect Dis 2024;79:1153-61):
(A) SAB associated with older age and comorbidity
(B) nosocomial intravenouscatheter-associated SAB in younger people without comorbidity
(C) community-acquired metastatic SAB
(D) SAB associated with chronic kidneydisease and haemodialysis
(E) SAB associated with injection drug use.
The SNAPstrat sub-study will determine if these subphenotypes can be identified amongst patients included in the trial, then determine if differential treatment effects exist for the trial interventions when patients are stratified by subphenotype membership.
Lead Investigator: Dr. Clark Russell, University of Edinburgh (clark.russell@ed.ac.uk)
TheSNAPstrat sub-study has three aims:
Aim 1: to determine if previously identified SAB subphenotypes can be reproducibly identified amongst patients recruited to the SNAP trial;
Aim 2: to determine if survival and microbiologic outcomes differ between patients in the usual care arm when stratified by predicted subphenotype membership;
Aim 3: to determine if subphenotypes are associated with differential treatment effects in the adjunctive treatment and other domains of the SNAP trial.
Ultimately, the potential benefit of this sub-study would be to inform patient stratification in SAB, permitting a more personalised medicine approach to treatment.
No further tests involving participants will be involved
No new data or samples will be collected. This study will retrospectively analyze data that has already been collected as part of the standard data collection procedures in SNAP
SNAP Trial
Cefazolin Versus Penicillin for Penicillin-Susceptible Staphylococcus aureus Bacteremia: A Secondary Analysis of the SNAP Backbone Trials
Significance of S. aureus bacteriuria in patients hospitalized with S. aureus bacteremia
A statistical genomics framework to improve prediction of treatment outcomes of Staphylococcus aureus bacteraemia (SAB)
