Impact of a Bundle of Interventions on Quality-of-Care Indicators for Staphylococcus aureus Bacteraemia: A Single-Centre, Quasi-Experimental, Before-After Study.

Autor:	Casalini G; III Division of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco Hospital, 20157 Milan, Italy., Pagani C; Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli-Sacco, Luigi Sacco Hospital, 20157 Milan, Italy., Giacomelli A; III Division of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco Hospital, 20157 Milan, Italy.; Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20157 Milan, Italy., Galimberti L; Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli-Sacco, Luigi Sacco Hospital, 20157 Milan, Italy., Milazzo L; Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli-Sacco, Luigi Sacco Hospital, 20157 Milan, Italy., Coen M; I Division of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco Hospital, 20157 Milan, Italy., Reato S; III Division of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco Hospital, 20157 Milan, Italy.; Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20157 Milan, Italy., Caloni B; III Division of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco Hospital, 20157 Milan, Italy.; Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20157 Milan, Italy., Caronni S; III Division of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco Hospital, 20157 Milan, Italy.; Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20157 Milan, Italy., Pagano S; III Division of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco Hospital, 20157 Milan, Italy.; Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20157 Milan, Italy., Lazzarin S; III Division of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco Hospital, 20157 Milan, Italy.; Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20157 Milan, Italy., Ridolfo AL; III Division of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco Hospital, 20157 Milan, Italy., Rimoldi SG; Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli-Sacco, Luigi Sacco Hospital, 20157 Milan, Italy., Gori A; Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20157 Milan, Italy.; Centre for Multidisciplinary Research in Health Science (MACH), Università degli Studi di Milano, 20122 Milan, Italy.; II Division of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco Hospital, 20157 Milan, Italy., Antinori S; III Division of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco Hospital, 20157 Milan, Italy.; Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20157 Milan, Italy.
Jazyk:	angličtina
Zdroj:	Antibiotics (Basel, Switzerland) [Antibiotics (Basel)] 2024 Jul 12; Vol. 13 (7). Date of Electronic Publication: 2024 Jul 12.
DOI:	10.3390/antibiotics13070646
Abstrakt:	Staphylococcus aureus bacteraemia (SAB) is a life-threatening bloodstream infection. Improved adherence to quality-of-care indicators (QCIs) can significantly enhance patient outcomes. This quasi-experimental study evaluated the impact of a bundle of interventions on QCI adherence in adult patients with SAB. Additionally, a molecular rapid diagnostic test (mRDT) for S. aureus and methicillin resistance was introduced during weekdays. We compared pre-intervention (January-December 2022) and post-intervention (May 2023-April 2024) data on QCI adherence and time to appropriate treatment. A total of 56 and 40 SAB episodes were included in the pre- and post-intervention periods, respectively. Full QCI adherence significantly increased from 28.6% to 67.5% in the post-intervention period ( p < 0.001). The mRDT diagnosed SAB in eight cases (26.6%), but the time to achieve appropriate target therapy did not improve in the post-intervention period (54 h (IQR 30-74) vs. 72 h (IQR 51-83), p = 0.131). The thirty-day mortality rate was comparable between the two periods (17.9% vs. 12.5%, p = 0.476). This study demonstrates that a bundle of interventions can substantially improve adherence to SAB management QCIs.
Databáze:	MEDLINE
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