Outcomes of Intervention by Multidisciplinary Antimicrobial Stewardship Team for Treating Staphylococcus aureus bacteremia
Tatsuro MITSUHASHI1)2), Ryuichi HIRANO1)3), Katsuyoshi OSANAI1)3) and Junichi KITAZAWA1)4) 1)Infection control office, Aomori Prefectural Central Hospital, 2)Division of Diabetes Mellitus and Endocrinology, Aomori Prefectural Central Hospital, 3)Division of pharmacy, Aomori Prefectural Central Hospital, 4)Division of Clinical Laboratory, Aomori Prefectural Central Hospital
[Background] Staphylococcus aureus bacteremia (SAB) is known as an important nosocomial infection owing to its high mortality rate. We compared treatment items and survival rate among patients diagnosed with SAB pre- and post- to evaluate the effect of the intervention by the multidisciplinary antimicrobial stewardship team (AST) in our hospital. [Methods] The intervention was implemented from April 2015. In total, 102 patients diagnosed with SAB were enrolled in this study: 50 patients enrolled between January 2014 and December 2014 comprised the pre-intervention group, and 52 patients enrolled between January 2016 and December 2016 comprised the post-intervention group. We evaluated the survival rate and the achievement rate of the proposed bundles for patients with SAB using a hospital telephone as well as a tag function of an electronic medical chart provided by AST. [Results] A significant difference was observed in the proportion of echocardiography procedures conducted to rule out infective endocarditis (pre-intervention, 22.5% vs. post-intervention, 75%), follow-up blood culture tests to confirm the clearance of bacteria (pre-intervention, 45% vs. post-intervention, 82.5%), and >14 days of therapy using antibiotics that exhibited susceptibility to the isolated bacteria (pre-intervention, 42.5% vs. post-intervention, 75%). No significant difference was observed in the 30-day survival rate (pre-intervention, 73.8% vs. post-intervention 74.4%). [Conclusion] Our multidisciplinary intervention was efficient in implementing medical procedures required to evaluate complicated SAB. Although no significant difference was observed in the survival rate, our intervention without the board-certified membership of the Japanese Association for Infectious Diseases contributed to the improvement of process indicators among patients with SAB.
Key words:Staphylococcus aureus bacteremia, antimicrobial stewardship team
e-mail:
tatu.azu0101@outlook.jp
Received: July 23, 2018 Accepted: March 29, 2019
34 (4):227─233,2019
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