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http://hdl.handle.net/1942/26195
Title: | Management of bloodstream infections by infection specialists: an international ESCMID cross-sectional survey | Authors: | Diallo, Kevin Thilly, Nathalie Luc, Amandine BERAUD, Guillaume Ergonul, Onder Giannella, Maddalena Kofteridis, Diamantis Kostyanev, Tomislav Pano-Pardo, Jose Ramon Retamar, Pilar Kern, Winfried Pulcini, Celine |
Issue Date: | 2018 | Source: | INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS, 51(5), p. 794-798 | Abstract: | Bloodstream infections (BSIs) are common, however international guidelines are available only for methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia and candidaemia. This international ESCMID cross-sectional survey, open from December 2016 to February 2017, explored the management of BSIs by infection specialists. All infection specialists (senior or trainees) giving at least weekly advice on positive blood cultures could participate. Their practices were evaluated using six clinical vignettes presenting uncomplicated BSI cases. A total of 616 professionals from 56 countries participated [333/616 (54%) infectious diseases specialists, 188/616 (31%) clinical microbiologists], of whom 76% (468/616) were members of an antimicrobial stewardship team. Large variations in practice were noted, in particular for the Escherichia coli, Enterococcus faecalis and Pseudomonas aeruginosa vignettes. Echocardiography was considered standard of care by 81% (373/459) of participants for MRSA, 78% (400/510) for methicillin-susceptible S. aureus and 60% (236/395) for Candida albicans. Antimicrobial combination therapy was recommended by 2% (8/360) of respondents for C. albicans, 11% (43/378) for E. coli, 27% (114/420) for MRSA and 39% (155/393) for E. faecalis. Intravenous-to-oral switch was considered in 68% (285/418) for MRSA, 79% (306/388) for E. faecalis, 72% (264/366) for P. aeruginosa and 75% (270/362) for C. albicans. In multivariable analysis, IDSA guideline-compliant practice was more frequent among participants belonging to an antimicrobial stewardship team (aOR = 1.7, P = 0.018 for the MRSA vignette; and aOR = 2.0, P = 0.008 for the candidaemia vignette). This survey showed large variations in practice among infection specialists. International guidelines on management of BSI are urgently needed. (c) 2018 Elsevier B.V. and International Society of Chemotherapy. All rights reserved. | Notes: | Pulcini, C (reprint author), Ctr Hosp Reg Univ Nancy, Hop Brabois, Serv Malad Infect & Trop, Allee Morvan, F-54511 Vandoeuvre Les Nancy, France. celine.pulcini@univ-lorraine.fr | Keywords: | Antibiotic stewardship; Bacteraemia; Blood culture; Candidaemia; Questionnaire; Survey | Document URI: | http://hdl.handle.net/1942/26195 | ISSN: | 0924-8579 | e-ISSN: | 1872-7913 | DOI: | 10.1016/j.ijantimicag.2017.12.010 | ISI #: | 000432150700020 | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2019 |
Appears in Collections: | Research publications |
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