Impact of adherence to individual quality-of-care indicators on the prognosis of bloodstream infection due to Staphylococcus aureus : a prospective observational multicentre cohort
Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved..
OBJECTIVES: 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.
METHODS: 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.
RESULTS: 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.
DISCUSSION: 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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:29 |
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| Enthalten in: |
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases - 29(2023), 4 vom: 30. Apr., Seite 498-505 |
| Sprache: |
Englisch |
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| Links: |
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| Themen: |
Anti-Bacterial Agents |
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| Anmerkungen: |
Date Completed 04.04.2023 Date Revised 04.04.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.cmi.2022.10.019 |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM347981429 |
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| 100 | 1 | |a Escrihuela-Vidal, Francesc |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Impact of adherence to individual quality-of-care indicators on the prognosis of bloodstream infection due to Staphylococcus aureus |b a prospective observational multicentre cohort |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 04.04.2023 | ||
| 500 | |a Date Revised 04.04.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved. | ||
| 520 | |a OBJECTIVES: 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 | ||
| 520 | |a METHODS: 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 | ||
| 520 | |a RESULTS: 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 | ||
| 520 | |a DISCUSSION: 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 | ||
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Management | |
| 650 | 4 | |a Mortality | |
| 650 | 4 | |a Quality of care indicators | |
| 650 | 4 | |a Staphylococcus aureus | |
| 650 | 7 | |a Anti-Bacterial Agents |2 NLM | |
| 700 | 1 | |a Kaasch, Achim J |e verfasserin |4 aut | |
| 700 | 1 | |a Von Cube, Maja |e verfasserin |4 aut | |
| 700 | 1 | |a Rieg, Siegbert |e verfasserin |4 aut | |
| 700 | 1 | |a Kern, Winfried V |e verfasserin |4 aut | |
| 700 | 1 | |a Seifert, Harald |e verfasserin |4 aut | |
| 700 | 1 | |a Song, Kyoung-Ho |e verfasserin |4 aut | |
| 700 | 1 | |a Liao, Chun-Hsing |e verfasserin |4 aut | |
| 700 | 1 | |a Tilley, Robert |e verfasserin |4 aut | |
| 700 | 1 | |a Gott, Hannah |e verfasserin |4 aut | |
| 700 | 1 | |a Scarborough, Matt |e verfasserin |4 aut | |
| 700 | 1 | |a Gordon, Claire |e verfasserin |4 aut | |
| 700 | 1 | |a Llewelyn, Martin J |e verfasserin |4 aut | |
| 700 | 1 | |a Kuehl, Richard |e verfasserin |4 aut | |
| 700 | 1 | |a Morata, Laura |e verfasserin |4 aut | |
| 700 | 1 | |a Soriano, Alex |e verfasserin |4 aut | |
| 700 | 1 | |a Edgeworth, Jonathan |e verfasserin |4 aut | |
| 700 | 1 | |a De Gopegui, Enrique Ruiz |e verfasserin |4 aut | |
| 700 | 1 | |a Nsutebu, Emmanuel |e verfasserin |4 aut | |
| 700 | 1 | |a Cisneros, José Miguel |e verfasserin |4 aut | |
| 700 | 1 | |a Fowler, Vance G |e verfasserin |4 aut | |
| 700 | 1 | |a Thwaites, Guy |e verfasserin |4 aut | |
| 700 | 1 | |a López-Contreras, Joaquín |e verfasserin |4 aut | |
| 700 | 1 | |a Barlow, Gavin |e verfasserin |4 aut | |
| 700 | 1 | |a Ternavasio-De La Vega, Hugo Guillermo |e verfasserin |4 aut | |
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