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Moving beyond unsolicited consultation: additional impact of a structured intervention on mortality in Staphylococcus aureus bacteraemia.

dc.contributor.authorPerez-Rodriguez, Maria Teresa
dc.contributor.authorSousa, Adrian
dc.contributor.authorLopez-Cortes, Luis Eduardo
dc.contributor.authorMartinez-Lamas, Lucia
dc.contributor.authorVal, Nuria
dc.contributor.authorBaroja, Aida
dc.contributor.authorNodar, Andres
dc.contributor.authorVasallo, Francisco
dc.contributor.authorAlvarez-Fernandez, Maximiliano
dc.contributor.authorCrespo, Manuel
dc.contributor.authorRodriguez-Baño, Jesus
dc.date.accessioned2023-01-25T10:29:09Z
dc.date.available2023-01-25T10:29:09Z
dc.date.issued2019
dc.description.abstractSome evidence-based bundles have tried to standardize the management of Staphylococcus aureus bacteraemia (SAB) to improve the outcome. The aim of our study was to analyse the additional impact on mortality of a structured intervention in patients with SAB. Compliance with the bundle was evaluated in an ambispective cohort of patients with SAB, which included a retrospective cohort [including patients treated before and after the implementation of a bacteraemia programme (no-BP and BP, respectively)] and a prospective cohort (i-BP), in which an additional specific intervention for bundle application was implemented. Multivariate logistic regression was used to measure the influence of the independent variables including compliance with the bundle on 14 and 30 day crude mortality. A total of 271 adult patients with SAB were included. Mortality was significantly different among the three groups (no-BP, BP and i-BP): mortality at 14 days was 18% versus 7% versus 2%, respectively, P = 0.002; and mortality at 30 days was 20% versus 12% versus 5%, respectively, P = 0.011. The factors associated with 14 and 30 day mortality in multivariable analysis were heart failure (OR = 7.63 and OR = 2.27, respectively), MRSA infection (OR = 4.02 and OR = 4.37, respectively) and persistent bacteraemia (OR = 11.01 and OR = 7.83, respectively); protective factors were catheter-related bacteraemia (OR = 0.16 and OR = 0.19, respectively) and >75% bundle compliance (OR = 0.15 and OR = 0.199, respectively). Time required to perform the intervention and the follow-up was 50 min (IQR 40-55 min) per patient. High-level compliance with a standardized bundle of intervention for management of SAB that requires little time was associated with lower mortality at 14 and 30 days.
dc.description.versionSi
dc.identifier.citationPérez-Rodríguez MT, Sousa A, López-Cortés LE, Martínez-Lamas L, Val N, Baroja A, et al. Moving beyond unsolicited consultation: additional impact of a structured intervention on mortality in Staphylococcus aureus bacteraemia. J Antimicrob Chemother. 2019 Apr 1;74(4):1101-1107.
dc.identifier.doi10.1093/jac/dky556
dc.identifier.essn1460-2091
dc.identifier.pmid30689894
dc.identifier.unpaywallURLhttps://academic.oup.com/jac/article-pdf/74/4/1101/28078278/dky556.pdf
dc.identifier.urihttp://hdl.handle.net/10668/13473
dc.issue.number4
dc.journal.titleThe Journal of antimicrobial chemotherapy
dc.journal.titleabbreviationJ Antimicrob Chemother
dc.language.isoen
dc.organizationInstituto de Biomedicina de Sevilla-IBIS
dc.organizationHospital Universitario Virgen Macarena
dc.page.number1101-1107
dc.provenanceRealizada la curación de contenido 17/06/2025.
dc.publisherOxford University Press
dc.pubmedtypeJournal Article
dc.pubmedtypeResearch Support, Non-U.S. Gov't
dc.relation.publisherversionhttps://academic.oup.com/jac/article-lookup/doi/10.1093/jac/dky556
dc.rights.accessRightsRestricted Access
dc.subjectBacteremia
dc.subjectEvidence-Based Practice
dc.subjectHealth Impact Assessment
dc.subjectOdds Ratio
dc.subjectStaphylococcal Infections
dc.subject.decsMortalidad
dc.subject.decsPacientes
dc.subject.decsCatéteres
dc.subject.decsStaphylococcus aureus resistente a Meticilina
dc.subject.decsInsuficiencia cardíaca
dc.subject.decsInfecciones
dc.subject.meshAdult
dc.subject.meshAged
dc.subject.meshAged, 80 and over
dc.subject.meshDisease Management
dc.subject.meshFemale
dc.subject.meshHumans
dc.subject.meshMale
dc.subject.meshMethicillin-Resistant Staphylococcus aureus
dc.subject.meshMiddle Aged
dc.subject.meshQuality Indicators, Health Care
dc.subject.meshReferral and Consultation
dc.subject.meshRisk Factors
dc.subject.meshStaphylococcus aureus
dc.titleMoving beyond unsolicited consultation: additional impact of a structured intervention on mortality in Staphylococcus aureus bacteraemia.
dc.typeresearch article
dc.type.hasVersionVoR
dc.volume.number74
dspace.entity.typePublication

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