Title :

Management and outcome of bloodstream infections: a prospective survey in 121 french hospitals (spa-bact survey)

Author(s) :

Robineau, Olivier [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Robert, Jerome [Auteur]
Sorbonne Université [SU]
Rabaud, Christian [Auteur]
Centre Hospitalier Régional Universitaire de Nancy [CHRU Nancy]
Bedos, Jean-Pierre [Auteur]
Unité de Soins Intensifs [CH Versailles]
Varon, Emmanuelle [Auteur]
Hôpital Européen Georges Pompidou [APHP] [HEGP]
Pean, Yves [Auteur]
Gauzit, Remy [Auteur]
Hôpital Cochin [AP-HP]
Alfandari, Serge [Auteur]
Centre Hospitalier Tourcoing

Journal title :

Infection and drug resistance

Abbreviated title :

Infect. Drug Resistance

Volume number :

11

Pages :

1359-1368

Publication date :

2018-01-01

ISSN :

1178-6973

English keyword(s) :

mortality
bloodstream infections
antimicrobial management team
community-acquired infection
health care-related infection

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Bloodstream infections (BSIs) are severe infections that can be community or hospital acquired. Effects of time to appropriate treatment and impact of antimicrobial management team are discussed in terms of outcome of BSI. ...
Show more >Bloodstream infections (BSIs) are severe infections that can be community or hospital acquired. Effects of time to appropriate treatment and impact of antimicrobial management team are discussed in terms of outcome of BSI. We sought to evaluate the impact of initial BSI management on short-term mortality. A prospective, multicenter survey was conducted in 121 French hospitals. Participants declaring BSI during a 1-month period were included consecutively. Data on patient comorbidities, illness severity, BSI management, and resistance profile of bacterial strains were collected. Predictors of 10-day mortality were identified by multivariate regression for overall BSI, health care-related and hospital-acquired BSI. We included 1,952 BSIs. More than a third of them were hospital acquired (39%). Multidrug resistance was identified in 10% of cases, mainly in health care-related BSI. Empirical therapy and targeted therapy were appropriate for 61% and 94% of cases, respectively. Increased 10-day mortality was associated with severe sepsis, septic shock, increasing age, and any focus other than the urinary tract. Decreased mortality was associated with receiving at least one active antibiotic within the first 48 hours. Intervention of antimicrobial management team during the acute phase of BSI was associated with a decreased mortality at day 10 in the overall population and in health care-related BSI. Optimizing BSI management by increasing rapidity of appropriate treatment initiation may decrease short-term mortality, even in countries with low rate of multidrug-resistant organisms. Early intervention of antimicrobial management team is crucial in terms of mortality.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
Université de Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Submission date :

2019-12-09T18:19:07Z
2020-04-01T14:21:57Z