851. Compliance with Guidelines for Management of Staphylococcus aureus Bacteremia and its Effect on Mortality
Open Forum Infectious Diseases(2020)
摘要
Abstract Background In the US, Staphylococcus aureus Bacteremia (SAB) occurs in about 19.7 /100,000 people. A recent increase in methicillin-resistant Staphylococcus aureus (MRSA) bacteremia infections rate and mortality has led to more infectious diseases (ID) consultations. We assessed if an infectious diseases consultation within 7 days of initial blood culture results was associated to greater compliance with Infectious Diseases Society of America (IDSA) guidelines for managing Staphylococcus aureus bacteremia and a decrease in all-cause mortality and relapse within 90 days. Methods A retrospective cohort of patients admitted to two community hospitals from January 2014 to June 2016 with a positive blood culture for methicillin-susceptible S. aureus (MSSA), MRSA, or coagulase-negative Staphylococcus were included in the study. I. Patients were excluded if they were immunocompromised, had a polymicrobial blood stream infection, died within first 48 hours of admission, left against medical advice during treatment or participated in another study requiring an alternative treatment strategy. Results A total of 331 patients were included in the analysis. A significantly higher proportion of patients with complicated SAB had an ID consult (61% vs. 17.5%, p< .0001) and for uncomplicated SAB the reverse was true (39% vs 79%, P< .0001). An ID consult was associated with increased compliance with IDSA guidelines (75% vs. 5%, p< .0001). Patients with an ID consult had a significantly higher duration of antibiotic treatment [30(14-42) vs. 5(1.5-12), p< .0001], an earlier start of treatment in number of days [0(0-7) vs. 0(0-12), p=0.036] and a lower mortality within 90 days of blood culture (61% vs. 17.5%, p< .0001). Logistic regression model showed than an ID consult reduced 90-day mortality by 69%, OR 0.313[CI 95 %(0.313-0.154), p=0.001] and transesophageal echography by 78%, OR 0.228[CI 95 %(0.228-0.052), p=0.05]. Population characteristics and outcomes Conclusion ID consultation in the setting of SAB has been shown to increase compliance with IDSA guidelines and reduce 90-day mortality. Disclosures All Authors: No reported disclosures
更多查看译文
AI 理解论文
溯源树
样例
生成溯源树,研究论文发展脉络
Chat Paper
正在生成论文摘要