Abstract
BACKGROUND: Staphylococcus aureus bacteremia (SAB) is associated with significant morbidity and mortality in hospitalized adults. OBJECTIVE: We aimed to identify current practice patterns in the management of SAB, and to evaluate their association with clinical outcomes. DESIGN: Retrospective cohort study. SETTING: A 1558-bed tertiary care teaching hospital. PATIENTS: Adult patients hospitalized between January 1, 2012 through April 30, 2013, who had at least 1 positive blood culture with S aureus. INTERVENTION: None MEASUREMENTS: Electronic medical records were reviewed and the processes of care in the management of SAB were identified. The main outcome was clinical failure, defined as a composite endpoint of in-hospital mortality and persistent bacteremia. RESULTS: Two hundred fifty episodes of SAB occurred in 241 patients, and 78 (32.4%) had clinical failure. Processes of care that impacted the risk of clinical failure included: timing of follow-up blood cultures (delays of >4 days had a relative risk [RR] of 6.6; 95% confidence interval [CI]: 2.1-20.5; P=0.001), consultation with infectious diseases specialist within 6 days from diagnosis of SAB (RR: 0.3; 95% CI: 0.1-0.9; P=0.03), and use of β-lactams in patients with methicillin-susceptible S aureus bacteremia (RR: 0.1; 95% CI: 0.04-0.5; P=0.002). CONCLUSIONS: The processes of care identified in our study could serve as quality and patient safety indicators for the management of SAB.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 27-32 |
| Number of pages | 6 |
| Journal | Journal of Hospital Medicine |
| Volume | 11 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 1 2016 |
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ASJC Scopus subject areas
- Health Policy
- Assessment and Diagnosis
- Care Planning
- Fundamentals and skills
- Leadership and Management
Cite this
Performance of processes of care and outcomes in patients with Staphylococcus aureus bacteremia. / Rosa, Rossana; Wawrzyniak, Andrew; Sfeir, Maroun; Smith, Laura; Abbo, Lilian.
In: Journal of Hospital Medicine, Vol. 11, No. 1, 01.01.2016, p. 27-32.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Performance of processes of care and outcomes in patients with Staphylococcus aureus bacteremia
AU - Rosa, Rossana
AU - Wawrzyniak, Andrew
AU - Sfeir, Maroun
AU - Smith, Laura
AU - Abbo, Lilian
PY - 2016/1/1
Y1 - 2016/1/1
N2 - BACKGROUND: Staphylococcus aureus bacteremia (SAB) is associated with significant morbidity and mortality in hospitalized adults. OBJECTIVE: We aimed to identify current practice patterns in the management of SAB, and to evaluate their association with clinical outcomes. DESIGN: Retrospective cohort study. SETTING: A 1558-bed tertiary care teaching hospital. PATIENTS: Adult patients hospitalized between January 1, 2012 through April 30, 2013, who had at least 1 positive blood culture with S aureus. INTERVENTION: None MEASUREMENTS: Electronic medical records were reviewed and the processes of care in the management of SAB were identified. The main outcome was clinical failure, defined as a composite endpoint of in-hospital mortality and persistent bacteremia. RESULTS: Two hundred fifty episodes of SAB occurred in 241 patients, and 78 (32.4%) had clinical failure. Processes of care that impacted the risk of clinical failure included: timing of follow-up blood cultures (delays of >4 days had a relative risk [RR] of 6.6; 95% confidence interval [CI]: 2.1-20.5; P=0.001), consultation with infectious diseases specialist within 6 days from diagnosis of SAB (RR: 0.3; 95% CI: 0.1-0.9; P=0.03), and use of β-lactams in patients with methicillin-susceptible S aureus bacteremia (RR: 0.1; 95% CI: 0.04-0.5; P=0.002). CONCLUSIONS: The processes of care identified in our study could serve as quality and patient safety indicators for the management of SAB.
AB - BACKGROUND: Staphylococcus aureus bacteremia (SAB) is associated with significant morbidity and mortality in hospitalized adults. OBJECTIVE: We aimed to identify current practice patterns in the management of SAB, and to evaluate their association with clinical outcomes. DESIGN: Retrospective cohort study. SETTING: A 1558-bed tertiary care teaching hospital. PATIENTS: Adult patients hospitalized between January 1, 2012 through April 30, 2013, who had at least 1 positive blood culture with S aureus. INTERVENTION: None MEASUREMENTS: Electronic medical records were reviewed and the processes of care in the management of SAB were identified. The main outcome was clinical failure, defined as a composite endpoint of in-hospital mortality and persistent bacteremia. RESULTS: Two hundred fifty episodes of SAB occurred in 241 patients, and 78 (32.4%) had clinical failure. Processes of care that impacted the risk of clinical failure included: timing of follow-up blood cultures (delays of >4 days had a relative risk [RR] of 6.6; 95% confidence interval [CI]: 2.1-20.5; P=0.001), consultation with infectious diseases specialist within 6 days from diagnosis of SAB (RR: 0.3; 95% CI: 0.1-0.9; P=0.03), and use of β-lactams in patients with methicillin-susceptible S aureus bacteremia (RR: 0.1; 95% CI: 0.04-0.5; P=0.002). CONCLUSIONS: The processes of care identified in our study could serve as quality and patient safety indicators for the management of SAB.
UR - http://www.scopus.com/inward/record.url?scp=84953357796&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84953357796&partnerID=8YFLogxK
U2 - 10.1002/jhm.2479
DO - 10.1002/jhm.2479
M3 - Article
C2 - 26381394
AN - SCOPUS:84953357796
VL - 11
SP - 27
EP - 32
JO - Journal of hospital medicine (Online)
JF - Journal of hospital medicine (Online)
SN - 1553-5606
IS - 1
ER -