Article
Impact of adherence to individual quality-of-care indicators on the prognosis of bloodstream infection due to Staphylococcus aureus a prospective observational multicentre cohort
Author/s | Escrihuela-Vidal, Francesc
Kaasch, Achim J. Von Cube, Maja Rieg, Siegbert Kern, Winfried V. Seifert, Harald Cisneros, José Miguel Rodríguez-Baño, Jesús López-Cortés, Luis Eduardo |
Department | Universidad de Sevilla. Departamento de Medicina |
Publication Date | 2023-04 |
Deposit Date | 2023-05-08 |
Published in |
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Abstract | 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 ... 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. |
Funding agencies | Plan Nacional de I+D+I 2013-2016 Instituto de Salud Carlos III Ministerio de Economía, Industria y Competitividad Red Española de Investigación en Enfermedades Infecciosas Fondo Europeo de Desarrollo Regional 'Una forma de alcanzar Europa, Programa Operativo Crecimiento Inteligente 2014-2020' |
Project ID. | RD16/0016 /0001 |
Citation | Escrihuela-Vidal, F., Kaasch, A.J., Von Cube, M., Rieg, S., Kern, W.V., Seifert, H.,...,López-Cortés, L.E. (2023). Impact of adherence to individual quality-of-care indicators on the prognosis of bloodstream infection due to Staphylococcus aureus a prospective observational multicentre cohort. Clinical Microbiology and Infection, 29 (4), 498-505. https://doi.org/10.1016/j.cmi.2022.10.019. |
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