| Autor: |
Francesc Escrihuela-Vidal, Achim J. Kaasch, Maja Von Cube, Siegbert Rieg, Winfried V. Kern, Harald Seifert, Kyoung-Ho Song, Chun-Hsing Liao, Robert Tilley, Hannah Gott, Matt Scarborough, Claire Gordon, Martin J. Llewelyn, Richard Kuehl, Laura Morata, Alex Soriano, Jonathan Edgeworth, Enrique Ruiz De Gopegui, Emmanuel Nsutebu, José Miguel Cisneros, Vance G. Fowler, Guy Thwaites, Joaquín López-Contreras, Gavin Barlow, Hugo Guillermo Ternavasio-De La Vega, Jesús Rodríguez-Baño, Luis Eduardo López-Cortés |
| Přispěvatelé: |
Group, International Staphylococcus Aureus Collaboration Study, Infections, The European Society of Clinical Microbiology and Infectious Diseases Study Group For Bloodstream |
| Rok vydání: |
2022 |
| Předmět: |
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| Zdroj: |
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases. |
| ISSN: |
1469-0691 |
| Popis: |
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. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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