Portal de investigação
The role of centre and country factors on process and outcome indicators in critically ill patients with hospital-acquired bloodstream infections
Data de publicação:
Data Ahead of Print:
Autores da FMUP
Participantes de fora da FMUP
- Buetti, Niccolo
- Tabah, Alexis
- Setti, Nour
- Ruckly, Stephane
- Barbier, Francois
- Akova, Murat
- Aslan, Abdullah Tarik
- Leone, Marc
- Bassetti, Matteo
- Morris, Andrew Conway
- Arvaniti, Kostoula
- Ferrer, Ricard
- Qiu, Haibo
- Montrucchio, Giorgia
- Cortegiani, Andrea
- Kayaaslan, Bircan
- De Bus, Liesbet
- De Waele, Jan J.
- Timsit, Jean-Francois
- European Soc Intensive Care Med
- Eurobact-2 Study Group
- Study Grp Infections
- Outcomerea Network
Unidades de investigação
Abstract
Purpose: The primary objective of this study was to evaluate the associations between centre/country-based factors and two important process and outcome indicators in patients with hospital-acquired bloodstream infections (HABSI). Methods: We used data on HABSI from the prospective EUROBACT-2 study to evaluate the associations between centre/country factors on a process or an outcome indicator: adequacy of antimicrobial therapy within the first 24 h or 28-day mortality respectively. Mixed logistical models with clustering by centre identified factors associated with both indicators. Results: Two thousand two hundred nine patients from two hundred one intensive care units (ICUs) were included in forty-seven countries. Overall 51% (n = 1128) of patients received an adequate antimicrobial therapy and the 28-day mortality was 38% (n = 839). The availability of therapeutic drug monitoring (TDM) for aminoglycosides everyday [odds ratio (OR) 1.48 95% confidence interval (CI) 1.03-2.14] or within a few hours (OR 1.79 95% CI 1.34-2.38) surveillance cultures for multidrug-resistant organism carriage performed weekly (OR 1.45 95% CI 1.09-1.93) and increasing Human Development Index (HDI) values were associated with adequate antimicrobial therapy. The presence of intermediate care beds (OR 0.63 95% CI 0.47-0.84) TDM for aminoglycoside available everyday (OR 0.66 95% CI 0.44-1.00) or within a few hours (OR 0.5 95% CI 0.37-0.70) 24/7 consultation of clinical pharmacists (OR 0.67 95% CI 0.47-0.95)percentage of vancomycin-resistant enterococci ( VRE) between 10% and 25% in the ICU (OR 1.67 95% CI 1.00-2.80) and decreasing HDI values were associated with 28-day mortality. Conclusion: Centre/country factors should be targeted for future interventions to improve management strategies and outcome of HABSI in ICU patients.
Dados da publicação
- ISSN/ISSNe:
- 1432-1238, 0342-4642
- Tipo:
- Article
- Páginas:
- 873-889
- PubMed:
- 38498170
Intensive Care Medicine Springer Verlag
Citações Recebidas na Web of Science: 9
Documentos
- Não há documentos
Filiações
Keywords
- Hospital-acquired bloodstream infections; Bacteraemia; Centre; Process indicator; Outcome indicator
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Estudo Clínico Académico . 2022
Citar a publicação
Buetti N,Tabah A,Setti N,Ruckly S,Barbier F,Akova M,Aslan AT,Leone M,Bassetti M,Morris AC,Arvaniti K,Paiva J,Ferrer R,Qiu H,Montrucchio G,Cortegiani A,Kayaaslan B,De Bus L,De Waele JJ,Timsit J,European Soc Intensive Care M,Eurobact G,Study GRP,Outcomerea N. The role of centre and country factors on process and outcome indicators in critically ill patients with hospital-acquired bloodstream infections. Intensive Care Med. 2024. 50. (6):p. 873-889. IF:38,900. (1).
