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962. Impact of Care Bundle Element Compliance on Clinical Outcomes for Pediatric Patients with Staphylococcus aureus Bacteremia

BACKGROUND: Staphylococcus aureus bacteremia (SAB) is a major cause of morbidity and mortality in children. The Infectious Disease Society of America (IDSA) outlines standards of care for patients with SAB known to positively impact morbidity and mortality, which have been validated in numerous stud...

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Autores principales: Pallotta, Raneem, Davidge, Karen, Riggsbee, Daniel, Tribble, Alison, Nagel, Jerod
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10679191/
http://dx.doi.org/10.1093/ofid/ofad500.023
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author Pallotta, Raneem
Davidge, Karen
Riggsbee, Daniel
Tribble, Alison
Nagel, Jerod
author_facet Pallotta, Raneem
Davidge, Karen
Riggsbee, Daniel
Tribble, Alison
Nagel, Jerod
author_sort Pallotta, Raneem
collection PubMed
description BACKGROUND: Staphylococcus aureus bacteremia (SAB) is a major cause of morbidity and mortality in children. The Infectious Disease Society of America (IDSA) outlines standards of care for patients with SAB known to positively impact morbidity and mortality, which have been validated in numerous studies within the adult population. However, there is limited data evaluating the clinical impact of compliance with these standards in pediatric patients. The primary objective of this study was to evaluate the impact of compliance with seven key bundle elements for the treatment of SAB in children. METHODS: This was a retrospective, single-center, cohort study of pediatric patients aged 18 years or younger with SAB admitted to Michigan Medicine from 2019–2022. The seven bundle elements evaluated included timely initiation of antibiotics, appropriate targeted antibiotic therapy, ID consultation, documented culture clearance, an echocardiogram for high-risk patients, source control, and appropriate duration of therapy. To be considered fully compliant, patients had to meet all seven elements. The primary endpoint was a composite endpoint of mortality and 30-day infection-related readmission rates. RESULTS: A total of 73 patients were included; 40 (54.8%) met the fully compliant bundle definition, and 33 (45.2%) were partially compliant. Fully compliant patients had a significantly lower incidence of combined mortality and readmission (7.5% vs. 24.2%; p = 0.0466). Lack of appropriate targeted therapy and lack of source control in patients with a removable source were the most common reasons for not meeting full bundle compliance (Table 1). Appropriate duration of therapy was met in 78.8% of patients in the partially compliant group (26/33, p = 0.0026). [Figure: see text] [Figure: see text] CONCLUSION: Adherence to all bundle elements was associated with lower incidences of mortality and readmission. The results of this study will assist in quality improvement interventions at Michigan Medicine. DISCLOSURES: All Authors: No reported disclosures
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spelling pubmed-106791912023-11-27 962. Impact of Care Bundle Element Compliance on Clinical Outcomes for Pediatric Patients with Staphylococcus aureus Bacteremia Pallotta, Raneem Davidge, Karen Riggsbee, Daniel Tribble, Alison Nagel, Jerod Open Forum Infect Dis Abstract BACKGROUND: Staphylococcus aureus bacteremia (SAB) is a major cause of morbidity and mortality in children. The Infectious Disease Society of America (IDSA) outlines standards of care for patients with SAB known to positively impact morbidity and mortality, which have been validated in numerous studies within the adult population. However, there is limited data evaluating the clinical impact of compliance with these standards in pediatric patients. The primary objective of this study was to evaluate the impact of compliance with seven key bundle elements for the treatment of SAB in children. METHODS: This was a retrospective, single-center, cohort study of pediatric patients aged 18 years or younger with SAB admitted to Michigan Medicine from 2019–2022. The seven bundle elements evaluated included timely initiation of antibiotics, appropriate targeted antibiotic therapy, ID consultation, documented culture clearance, an echocardiogram for high-risk patients, source control, and appropriate duration of therapy. To be considered fully compliant, patients had to meet all seven elements. The primary endpoint was a composite endpoint of mortality and 30-day infection-related readmission rates. RESULTS: A total of 73 patients were included; 40 (54.8%) met the fully compliant bundle definition, and 33 (45.2%) were partially compliant. Fully compliant patients had a significantly lower incidence of combined mortality and readmission (7.5% vs. 24.2%; p = 0.0466). Lack of appropriate targeted therapy and lack of source control in patients with a removable source were the most common reasons for not meeting full bundle compliance (Table 1). Appropriate duration of therapy was met in 78.8% of patients in the partially compliant group (26/33, p = 0.0026). [Figure: see text] [Figure: see text] CONCLUSION: Adherence to all bundle elements was associated with lower incidences of mortality and readmission. The results of this study will assist in quality improvement interventions at Michigan Medicine. DISCLOSURES: All Authors: No reported disclosures Oxford University Press 2023-11-27 /pmc/articles/PMC10679191/ http://dx.doi.org/10.1093/ofid/ofad500.023 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Abstract
Pallotta, Raneem
Davidge, Karen
Riggsbee, Daniel
Tribble, Alison
Nagel, Jerod
962. Impact of Care Bundle Element Compliance on Clinical Outcomes for Pediatric Patients with Staphylococcus aureus Bacteremia
title 962. Impact of Care Bundle Element Compliance on Clinical Outcomes for Pediatric Patients with Staphylococcus aureus Bacteremia
title_full 962. Impact of Care Bundle Element Compliance on Clinical Outcomes for Pediatric Patients with Staphylococcus aureus Bacteremia
title_fullStr 962. Impact of Care Bundle Element Compliance on Clinical Outcomes for Pediatric Patients with Staphylococcus aureus Bacteremia
title_full_unstemmed 962. Impact of Care Bundle Element Compliance on Clinical Outcomes for Pediatric Patients with Staphylococcus aureus Bacteremia
title_short 962. Impact of Care Bundle Element Compliance on Clinical Outcomes for Pediatric Patients with Staphylococcus aureus Bacteremia
title_sort 962. impact of care bundle element compliance on clinical outcomes for pediatric patients with staphylococcus aureus bacteremia
topic Abstract
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10679191/
http://dx.doi.org/10.1093/ofid/ofad500.023
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