Performance of processes of care and outcomes in patients with Staphylococcus aureus bacteremia

Rossana Rosa, Andrew Wawrzyniak, Maroun Sfeir, Laura Smith, Lilian Abbo

Research output: Contribution to journalArticle

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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 languageEnglish (US)
Pages (from-to)27-32
Number of pages6
JournalJournal of Hospital Medicine
Volume11
Issue number1
DOIs
StatePublished - Jan 1 2016

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Bacteremia
Staphylococcus aureus
Confidence Intervals
Safety Management
Lactams
Methicillin
Electronic Health Records
Tertiary Healthcare
Patient Safety
Hospital Mortality
Teaching Hospitals
Communicable Diseases
Cohort Studies
Referral and Consultation
Retrospective Studies
Morbidity
Mortality

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 journalArticle

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