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Staphylococcus aureus bacteremia: impact of an intervention program in improving the clinical management and review of the clinical and molecular epidemiology.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients diagnosed bacteremia by S. aureus |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Follow recommendations based on scientific evidence to S. aureus bacteremia management | Behavioral |
| ||
| Measure | Description | Time Frame |
|---|---|---|
| The overall target is to assess if the implementation of an active intervention program improves clinical management of the disease, according to existing recommendations. | Identify evidence-based quality-of-care indicators (QCIs) for the management of Staphylococcus aureus bacteremia (SAB). See secondary objective for the definitions of QCIs | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Follow-up blood cultures performance of control blood culture 48-96h. | Description:Performance of control blood cultures 48-96 h after antimicrobial therapy was started regardless of clinical evolution Formula:Patients with follow-up blood culture collected×100/Patients alive at 96h. | 6 months |
| Early source control |
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Inclusion Criteria:
Exclusion Criteria:
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All patients diagnosed bacteremia by S. aureus attended in participating centers will be included
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| Name | Affiliation | Role |
|---|---|---|
| Jesús Rodríguez-Baño | Hospital Universitario Virgen Macarena | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospital de Puerto Real | Puerto Real | Cádiz | Spain | |||
| Hospital Costa del Sol |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23929889 | Result | Lopez-Cortes LE, Del Toro MD, Galvez-Acebal J, Bereciartua-Bastarrica E, Farinas MC, Sanz-Franco M, Natera C, Corzo JE, Lomas JM, Pasquau J, Del Arco A, Martinez MP, Romero A, Muniain MA, de Cueto M, Pascual A, Rodriguez-Bano J; REIPI/SAB group. Impact of an evidence-based bundle intervention in the quality-of-care management and outcome of Staphylococcus aureus bacteremia. Clin Infect Dis. 2013 Nov;57(9):1225-33. doi: 10.1093/cid/cit499. Epub 2013 Aug 8. |
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| Not to follow recommendations based on scientific evidence to S. aureus bacteremia management |
| Behavioral |
|
Description: Removal of nonpermanent vascular catheter whenever the catheter was suspected or confirmed as the source of SAB, or drainage of an abscess in <72 h. Formula: Patients in which the amenable source was removed in<72h×100/Patients with source amenable of removal/drainage |
| 6 months |
| Echocardiography in patients with clinical indications | Description: Performance of echocardiography in patients with complicated bacteremia or predisposing conditions for endocarditis. Formula: Patients with echocardiography×100/Patients with complicated bacteremia or predisposing condition for endocarditis,alive at 96h | 6 months |
| Early use of IV cloxacillin for meticillin susceptible Staphylococcus aureus as definitive therapy | Description: Definitive therapy with intravenous cloxacillin (at least 2 g every 6 h or adjusted based on renal function in renal failure) in cases of methicillin-susceptible strains (allergic patients excluded). Treatment should be started within the first 24 h after methicillin sensitivity was available. For hemodialysis patients, cefazolin 2 g after each hemodialysis session was acceptable Formula: Definitive therapy with IV cloxacillin×100/nonallergic Patients with methicillin-susceptible isolates. | 6 months |
| Adjustment of vancomycin dose according to trough levels. | Description: Measurement of trough levels of vancomycin in patients treated for at least 3 d with this antibiotic and adjustment of dose in order to achieve plasma trough levels between 15 and 20 mg/L in survivors Formula: Patients with trough level of vancomycin determined and dose adjusted×100/Patients treated with vancomycin,at 3d. | 6 months |
| Treatment duration according to the complexity of infection. | Description: Duration of antimicrobial therapy of at least 14 d for uncomplicated bacteremia and 28 d for complicated bacteremia. Sequential oral treatment with fluoroquinolone plus rifampin, trimethoprim-sulfamethoxazole, or linezolid was considered accepted in selected case. Formula:Patients with appropriate duration of therapy×100/P alive at 14 or 28d in uncomplicated or complicated bacteremia | 6 Months |
| Marbella |
| Málaga |
| Spain |
| Hospital de Torrecárdenas | Almería | Spain |
| Hospital de barcelona - SCIAS | Barcelona | Spain |
| Hospital de Cruces | Bilbao | Spain |
| Hospital Puerta del Mar | Cadiz | Spain |
| Hospital Reina Sofía | Córdoba | Spain |
| Hospital Virgen de las Nieves | Granada | Spain |
| Hospital Juan Ramón Jiménez | Huelva | Spain |
| Hospital de San Pedro | Logroño | Spain |
| Hospital Carlos Haya | Málaga | Spain |
| Hospital Virgen de la Victoria | Málaga | Spain |
| Hospital de la Arrixaca | Murcia | Spain |
| Hospital de Valdecillas | Santander | Spain |
| Hospital Universitario Virgen de la Macarena | Seville | Spain |
| Hospital Virgen de Valme | Seville | Spain |