RT Journal Article
T1 Management of bloodstream infections by infection specialists: an international ESCMID cross-sectional survey.
A1 Diallo, Kévin
A1 Thilly, Nathalie
A1 Luc, Amandine
A1 Beraud, Guillaume
A1 Ergonul, Önder
A1 Giannella, Maddalena
A1 Kofteridis, Diamantis
A1 Kostyanev, Tomislav
A1 Paňo-Pardo, José Ramón
A1 Retamar, Pilar
A1 Kern, Winfried
A1 Pulcini, Céline
A1 ESGAP, ESGBIS
K1 Antibiotic stewardship
K1 Bacteraemia
K1 Blood culture
K1 Candidaemia
K1 Questionnaire
K1 Survey
AB Bloodstream infections (BSIs) are common, however international guidelines are available only for methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia and candidaemia. This international ESCMID cross-sectional survey, open from December 2016 to February 2017, explored the management of BSIs by infection specialists. All infection specialists (senior or trainees) giving at least weekly advice on positive blood cultures could participate. Their practices were evaluated using six clinical vignettes presenting uncomplicated BSI cases. A total of 616 professionals from 56 countries participated [333/616 (54%) infectious diseases specialists, 188/616 (31%) clinical microbiologists], of whom 76% (468/616) were members of an antimicrobial stewardship team. Large variations in practice were noted, in particular for the Escherichia coli, Enterococcus faecalis and Pseudomonas aeruginosa vignettes. Echocardiography was considered standard of care by 81% (373/459) of participants for MRSA, 78% (400/510) for methicillin-susceptible S. aureus and 60% (236/395) for Candida albicans. Antimicrobial combination therapy was recommended by 2% (8/360) of respondents for C. albicans, 11% (43/378) for E. coli, 27% (114/420) for MRSA and 39% (155/393) for E. faecalis. Intravenous-to-oral switch was considered in 68% (285/418) for MRSA, 79% (306/388) for E. faecalis, 72% (264/366) for P. aeruginosa and 75% (270/362) for C. albicans. In multivariable analysis, IDSA guideline-compliant practice was more frequent among participants belonging to an antimicrobial stewardship team (aOR = 1.7, P = 0.018 for the MRSA vignette; and aOR = 2.0, P = 0.008 for the candidaemia vignette). This survey showed large variations in practice among infection specialists. International guidelines on management of BSI are urgently needed.
YR 2018
FD 2018-01-05
LK http://hdl.handle.net/10668/11979
UL http://hdl.handle.net/10668/11979
LA en
DS RISalud
RD Apr 14, 2025