Journal article
The role of centre and country factors on process and outcome indicators in critically ill patients with hospital-acquired bloodstream infections
Intensive care medicine, Vol.50(6), pp.873-889
06/01/2024
DOI: 10.1007/s00134-024-07348-0
PMCID: PMC11164726
PMID: 38498170
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.
Details
- Title: Subtitle
- The role of centre and country factors on process and outcome indicators in critically ill patients with hospital-acquired bloodstream infections
- Creators
- Niccolo Buetti - Université Paris CitéAlexis Tabah - Redcliffe HospitalNour Setti - InsermStephane Ruckly - Université Paris CitéFrancois Barbier - Centre hospitalier universitaire d'OrléansMurat Akova - Hacettepe UniversityAbdullah Tarik Aslan - Hacettepe UniversityMarc Leone - Hôpital NordMatteo Bassetti - Ospedale Policlinico San MartinoAndrew Conway Morris - Addenbrooke's HospitalKostoula Arvaniti - Papageorgiou General HospitalJose-Artur Paiva - Universidade do PortoRicard Ferrer - Vall d'Hebron Institut de RecercaHaibo Qiu - Zhongda Hospital Southeast UniversityGiorgia Montrucchio - University of TurinAndrea Cortegiani - University of PalermoBircan Kayaaslan - Ankara Yıldırım Beyazıt UniversityLiesbet De Bus - Ghent University HospitalJan J De Waele - Ghent University HospitalJean-Francois Timsit - Assistance Publique – Hôpitaux de ParisEUROBACT-2 Study GroupEuropean Society of Intensive Care Medicine (ESICM)European Society of Clinical Microbiology, the Infectious Diseases (ESCMID) Study GroupESCMID Study Group for Infections in Critically Ill Patients (ESGCIP)OUTCOMEREA NetworkOlusola A Idowu (Contributor)
- Resource Type
- Journal article
- Publication Details
- Intensive care medicine, Vol.50(6), pp.873-889
- DOI
- 10.1007/s00134-024-07348-0
- PMID
- 38498170
- PMCID
- PMC11164726
- NLM abbreviation
- Intensive Care Med
- ISSN
- 0342-4642
- eISSN
- 1432-1238
- Publisher
- Springer Nature
- Number of pages
- 17
- Grant note
- European Society of Intensive Care Medicine (ESICM) European Society of Clinical Microbiology and Infectious Diseases (ESCMID) study Group for Infections in Critically Ill Patients (ESGCIP) Norva Dahlia foundation Redcliffe Hospital Private Practice Trust Fund University of Geneva
- Language
- English
- Date published
- 06/01/2024
- Academic Unit
- Anesthesia
- Record Identifier
- 9984786567502771
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