Impact of adherence to individual quality-of-care indicators on the prognosis of bloodstream infection due to Staphylococcus aureus : a prospective observational multicentre cohort
Escrihuela-Vidal, Francesc (Hospital Universitari de Bellvitge)
Kaasch, Achim J. (Otto-von-Guericke University Magdeburg)
Von Cube, Maja (University of Freiburg)
Rieg, Siegbert (University of Freiburg)
Kern, Winfried V. (University of Freiburg)
Seifert, Harald (German Center. for Infection Research)
Song, Kyoung-Ho (Seoul National University College of Medicine)
Liao, Chun-Hsing (Far Eastern Memorial Hospital)
Tilley, Robert (Derriford Hospital)
Gott, Hannah (Derriford Hospital)
Scarborough, Mathew (Oxford University Hospitals National Health Service Foundation Trust)
Gordon, Claire (Oxford University Hospitals National Health Service Foundation Trust)
Llewelyn, Martin J. (Royal Sussex County Hospital)
Kuehl, Richard (University Hospital Basel (Basilea, Suïssa))
Morata, Laura (Hospital Clínic i Provincial de Barcelona)
Soriano Viladomiu, Alex (Hospital Clínic i Provincial de Barcelona)
Edgeworth, Jonathan (St Thomas' Hospital)
De Gopegui, Enrique Ruiz (Instituto de Investigación Sanitaria Illes Balears)
Nsutebu, Emmanuel (Royal Liverpool and Broadgreen University Teaching Hospital)
Cisneros, José Miguel (Instituto de Biomedicina de Sevilla)
Fowler, Vance G. (Duke University School of Medicine)
Thwaites, Guy (University of Oxford)
López-Contreras, Joaquín 1963- (Institut d'Investigació Biomèdica Sant Pau)
Barlow, Gavin (Hull and East Yorkshire Hospitals National Health Service Trust)
Ternavasio-De La Vega, Hugo Guillermo (Instituto de Investigación Biomédica de Salamanca)
Rodríguez-Baño, Jesús (Universidad de Sevilla)
López Cortés, Luis Eduardo (Hospital Universitario Virgen Macarena (Sevilla, Andalusia))
Universitat Autònoma de Barcelona

Fecha:	2023
Resumen:	To analyse the adherence and impact of quality-of-care indicators (QCIs) in the management of Staphylococcus aureus bloodstream infection in a prospective and multicentre cohort. Analysis of the prospective, multicentre international S. Aureus Collaboration cohort of S. Aureus bloodstream infection cases observed between January 2013 and April 2015. Multivariable analysis was performed to evaluate the impact of adherence to QCIs on 90-day mortality. A total of 1784 cases were included. Overall, 90-day mortality was 29. 9% and mean follow-up period was 118 days. Adherence was 67% (n = 1180/1762) for follow-up blood cultures, 31% (n = 416/1342) for early focus control, 77. 6% (n = 546/704) for performance of echocardiography, 75. 5% (n = 1348/1784) for adequacy of targeted antimicrobial therapy, 88. 6% (n = 851/960) for adequacy of treatment duration in non-complicated bloodstream infections and 61. 2% (n = 366/598) in complicated bloodstream infections. Full bundle adherence was 18. 4% (n = 328/1784). After controlling for immortal time bias and potential confounders, focus control (adjusted hazard ratio = 0. 76; 95% CI, 0. 59-0. 99; p 0. 038) and adequate targeted antimicrobial therapy (adjusted hazard ratio = 0. 75; 95% CI, 0. 61-0. 91; p 0. 004) were associated with low 90-day mortality. Adherence to QCIs in S. Aureus bloodstream infection did not reach expected rates. Apart from the benefits of application as a bundle, focus control and adequate targeted therapy were independently associated with low mortality.
Ayudas:	Ministerio de Economía y Competitividad RD16/0016/0001
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Management ; Mortality ; Quality of care indicators ; Staphylococcus aureus
Publicado en:	Clinical Microbiology and Infection, Vol. 29 Núm. 4 (april 2023) , p. 498-505, ISSN 1469-0691

DOI: 10.1016/j.cmi.2022.10.019
PMID: 36283610

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