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2024-11-04

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Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/228156

Effect of a bundle intervention on adherence to quality-of-care indicators and on clinical outcomes in patients with Staphylococcus aureus bacteraemia hospitalized in non-referral community hospitals

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https://doi.org/10.1093/jac/dkae298

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Background: Although a significant number of cases of Staphylococcus aureus bacteraemia (SAB) are managed at non-referral community hospitals, the impact of a bundle-of-care intervention in this setting has not yet been explored. Methods: We performed a quasi-experimental before-after study with the implementation of a bundle of care for the management of SAB at five non-referral community hospitals and a tertiary care university hospital. Structured recommendations for the five indicators selected to assess quality of care were provided to investigators before the implementation of the bundle and monthly thereafter. Primary endpoints were adherence to the bundle intervention and treatment failure, defined as death or relapse at 90 days of follow-up. Results: One hundred and seventy patients were included in the pre-intervention period and 103 in the intervention period. Patient characteristics were similar in both periods. Multivariate analysis controlling for potential confounders showed that performance of echocardiography was the only factor associated with improved adherence to the bundle in the intervention period (adjusted OR 2.13; 95% CI 1.13-4.02). Adherence to the bundle, performance of follow-up blood cultures, and adequate duration of antibiotic therapy for complicated SAB presented non-significant improvements. The intervention was not associated with a lower rate of 90 day treatment failure (OR 1.11; 95% CI 0.70-1.77). Conclusions: A bundle-of-care intervention for the management of SAB at non-referral community hospitals increased adherence to quality indicators, but did not significantly reduce rates of 90 day mortality or relapse.

Matèries

Staphylococcus aureus, Microbiologia, Avaluació de resultats (Assistència mèdica)

Matèries (anglès)

Staphylococcus aureus, Microbiology, Outcome assessment (Medical care)

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Articles publicats en revistes (Ciències Clíniques)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

Citació

ESCRIHUELA-VIDAL, Francesc, CHICO, Cristina, BORJABAD, Beatriz, VÁZQUEZ SÁNCHEZ, Daniel antonio, LÉRIDA, Ana, BLAS ESCUDERO, Elisa de, SANMARTÍ VILAMALA, Montserrat, LINARES GONZÁLEZ, Laura, SIMONETTI, Antonella francesca, COLOMA CONDE, Ana, MUELAS FERNANDEZ, Magdalena, DÍAZ BRITO, Vicens, HORNA, Gertrudis, ORIOL, Isabel, BERBEL, Dàmaris, CÀMARA MAS, Jordi, GRILLO, Sara, PUJOL ROJO, Miquel, CUERVO REQUENA, Guillermo, CARRATALÀ, Jordi, PROMISE Study Group. Effect of a bundle intervention on adherence to quality-of-care indicators and on clinical outcomes in patients with Staphylococcus aureus bacteraemia hospitalized in non-referral community hospitals. _Journal of Antimicrobial Chemotherapy_. 2024. Vol. 79, núm. 11, pàgs. 2858-2866. [consulta: 8 de abril de 2026]. ISSN: 0305-7453. [Disponible a: https://hdl.handle.net/2445/228156]

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