The role of centre and country factors on process and outcome indicators in critically ill patients with hospital-acquired bloodstream infections
- Autori: Buetti, N.; Tabah, A.; Setti, N.; Ruckly, S.; Barbier, F.; Akova, M.; Aslan, A.T.; Leone, M.; Bassetti, M.; Morris, A.C.; Arvaniti, K.; Paiva, J.; Ferrer, R.; Qiu, H.; Montrucchio, G.; Cortegiani, A.; Kayaaslan, B.; De Bus, L.; De Waele, J.J.; Timsit, J.; Tabah, A.; Lipman, J.; Pollock, H.; Margetts, B.; Udy, A.; Young, M.; Bhadange, N.; Tyler, S.; Ledtischke, A.; Finnis, M.; Dwivedi, J.; Saxena, M.; Biradar, V.; Soar, N.; Sarode, V.; Brewster, D.; Regli, A.; Weeda., E.; Ahmed, S.; Fourie, C.; Laupland, K.; Ramanan, M.; Walsham, J.; Meyer, J.; Litton, E.; Palermo, A.M.; Yap, T.; Eroglu, E.; Attokaran, A.G.; Jaramillo, C.; Nafees, K.M.K.; Rashid, N.A.H.A.; Walid, H.A.M.I.; Mon, T.; Moorthi, D.; Sudhirchandra, S.; Sridharan, D.D.; Haibo, Q.; Xie, J.; Wei-Hua, L.; Zhen, W.; Qian, C.; Luo, J.; Chen, X.; Wang, H.; Zhao, P.; Zhao, J.; Wusi, Q.; Mingmin, C.; Xu, L.; Yin, C.; Wang, R.; Wang, J.; Yin, Y.; Zhang, M.; Ye, J.; Hu, C.; Zhou, S.; Huang, M.; Yan, J.; Wang, Y.; Qin, B.; Ye, L.; Weifeng, X.; Peije, L.; Geng, N.; Ling, L.; Hayashi, Y.; Karumai, T.; Yamasaki, M.; Hashimoto, S.; Hosokawa, K.; Makino, J.; Matsuyoshi, T.; Kuriyama, A.; Shigemitsu, H.; Mishima, Y.; Nagashima, M.; Yoshida, H.; Fujitani, S.; Omori, K.; Rinka, H.; Saito, H.; Atobe, K.; Kato, H.; Takaki, S.; Sulaiman, H.; Hasan, M.S.; Jamaluddin, M.F.H.; Pheng, L.S.; Visvalingam, S.; Liew, M.T.; Wong, S.L.D.; Fong, K.K.; Rahman, H.B.A.; Noor, Z.M.; Tong, L.K.; Azman, A.H.; Mazlan, M.Z.; Ali, S.; Hernandez, A.M.; Abello, A.; Jeon, K.; Lee, S.; Park, S.; Park, S.Y.; Lim, S.Y.; Kwa, A.L.H.; Goh, Q.Y.; Ng, S.Y.; Lie, S.A.; Goh, K.J.; Li, A.Y.; Ong, C.Y.M.; Lim, J.Y.; Quah, J.L.; Ng, K.; Ng, L.X.L.; Yeh, T.Y.; Chou, N.; Cia, C.; Hu, T.; Kuo, L.; Ku, S.; Wongsurakiat, P.; Apichatbutr, Y.; Chiewroongroj, S.; Alsisi, A.; Nadeem, R.; Houfi, A.E.; Elhadidy, A.; Barsoum, M.; Osman, N.; Mostafa, T.; Elbahnasawy, M.; Saber, A.; Aldhalia, A.; Elmandouh, O.; Elsayed, A.; Elbadawy, M.A.; Awad, A.K.; Hemead, H.M.; Zand, F.; Ouhadian, M.; Borsi, S.H.; Mehraban, Z.; Kashipazha, D.; Ahmadi, F.; Savaie, M.; Soltani, F.; Rashidi, M.; Baghbanian, R.; Javaherforoosh, F.; Amiri, F.; Kiani, A.; Zargar, M.A.; Mahmoodpoor, A.; Aalinezhad, F.; Dabiri, G.; Sabetian, G.; Sarshad, H.; Masjedi, M.; Tajvidi, R.; Tabatabaei, S.M.N.; Ahmed, A.K.; Singer, P.; Kagan, I.; Rigler, M.; Belman, D.; Levin, P.; Harara, B.; Diab, A.; Abillama, F.; Ibrahim, R.; Fares, A.; Elhadi, M.; Buimsaedah, A.; Gamra, M.; Aqeelah, A.; Aliali, A.M.; Homaidan, A.G.S.; Almiqlash, B.; Bilkhayr, H.; Bouhuwaish, A.; Taher, A.S.; Abdulwahed, E.; Abousnina, F.A.; Hdada, A.K.; Jobran, R.; Hasan, H.B.; Hasan, R.S.B.; Abidi, K.; Serghini, I.; Seddiki, P.R.; Boukatta, B.; Kanjaa, N.; Mouhssine, D.; Wajdi, M.A.; Dendane, P.T.; Zeggwagh, P.A.A.; Housni, B.; Younes, O.; Hachimi, A.; Ghannam, A.; Belkhadir, Z.; Amro, S.; Jayyab, M.A.; Hssain, A.A.; Elbuzidi, A.; Karic, E.; Lance, M.; Nissar, S.; Sallam, H.; Elrabi, O.; Almekhlafi, G.A.; Awad, M.; Aljabbary, A.; Chaaban, M.K.; Abu-Sayf, N.; Al-Jadaan, M.; Bakr, L.; Bouaziz, M.; Turki, O.; Sellami, P.W.; Vidal, G.; Centeno, P.; Morvillo, L.N.; Acevedo, J.O.; Lopez, P.M.; Fernández, R.; Segura, M.; Nuccetelli, Y.; Montefiore, P.; Arias, M.; Reyes, L.F.; Ñamendys-Silva, S.A.; Romero-Gonzalez, J.P.; Hermosillo, M.; Castillo, R.A.; Leal, J.N.P.; Aguilar, C.G.; Herrera, M.O.G.; Villafuerte, M.V.E.; Lomeli-Teran, M.; Dominguez-Cherit, J.G.; Davalos-Alvarez, A.; Sánchez-Hurtado, L.; Tejeda-Huezo, B.; Perez-Nieto, O.R.; Tomas, E.D.; De Bus, L.; De Waele, J.; Francois, G.; Hollevoet, I.; Denys, W.; Bourgeois, M.; Vanderhaeghen, S.F.M.; Mesland, J.; Henin, P.; Haentjens, L.; Biston, P.; Noel, C.; Layos, N.; Misset, B.; De Schryver, N.; Serck, N.; Wittebole, X.; De Waele, E.; Opdenacker, G.; Kovacevic, P.; Zlojutro, B.; Filipovic-Grcic, I.; Custovic, A.; Radonic, R.; Brajkovic, A.V.; Persec, J.; Sakan, S.; Nikolic, M.; Lasic, H.; Leone, P.M.; Timsit, J.; R
- Anno di pubblicazione: 2024
- Tipologia: Articolo in rivista
- Parole Chiave: Bacteraemia; Centre; Hospital-acquired bloodstream infections; Outcome indicator; Process indicator;
- OA Link: http://hdl.handle.net/10447/630593
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 0.51, 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.