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Performance of processes of care and outcomes in patients with S taphylococcus aureus bacteremia
Author(s) -
Rosa Rossana,
Wawrzyniak Andrew,
Sfeir Maroun,
Smith Laura,
Abbo Lilian M.
Publication year - 2016
Publication title -
journal of hospital medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.128
H-Index - 65
eISSN - 1553-5606
pISSN - 1553-5592
DOI - 10.1002/jhm.2479
Subject(s) - medicine , bacteremia , staphylococcus aureus , retrospective cohort study , confidence interval , medical record , blood culture , hospital medicine , relative risk , intensive care medicine , emergency medicine , antibiotics , genetics , bacteria , microbiology and biotechnology , biology
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. Journal of Hospital Medicine 2016;11:27–32. © 2015 Society of Hospital Medicine