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00925njm 22002777a 4500 dc Escrihuela-Vidal, Francesc author Kaasch, Achim J author Von Cube, Maja author Rieg, Siegbert author Kern, Winfried V author Seifert, Harald author Song, Kyoung-Ho author Liao, Chun-Hsing author Tilley, Robert author Gott, Hannah author Scarborough, Matt author Gordon, Claire author Llewelyn, Martin J author Kuehl, Richard author Morata, Laura author Soriano, Alex author Edgeworth, Jonathan author Ruiz de Gopegui-Bordes, Enrique author Nsutebu, Emmanuel author Cisneros, José Miguel author Fowler, Vance G. author Thwaites, Guy author López-Contreras, Joaquín author Barlow, Gavin author Ternavasio-De La Vega, Hugo Guillermo author Rodriguez-Bano, Jesus author Lopez-Cortes, Luis Eduardo author 2023-04 Objectives: To analyse the adherence and impact of quality-of-care indicators (QCIs) in the management of Staphylococcus aureus bloodstream infection in a prospective and multicentre cohort. Methods: Analysis of the prospective, multicentre international S. Aureus Collaboration cohort of S. Aureus bloodstream infection cases observed between January 2013 and April 2015. Multivariable analysis was performed to evaluate the impact of adherence to QCIs on 90-day mortality. Results: A total of 1784 cases were included. Overall, 90-day mortality was 29.9% and mean follow-up period was 118 days. Adherence was 67% (n = 1180/1762) for follow-up blood cultures, 31% (n = 416/1342) for early focus control, 77.6% (n = 546/704) for performance of echocardiography, 75.5% (n = 1348/1784) for adequacy of targeted antimicrobial therapy, 88.6% (n = 851/960) for adequacy of treatment duration in non-complicated bloodstream infections and 61.2% (n = 366/598) in complicated bloodstream infections. Full bundle adherence was 18.4% (n = 328/1784). After controlling for immortal time bias and potential confounders, focus control (adjusted hazard ratio = 0.76; 95% CI, 0.59-0.99; p 0.038) and adequate targeted antimicrobial therapy (adjusted hazard ratio = 0.75; 95% CI, 0.61-0.91; p 0.004) were associated with low 90-day mortality. Discussion: Adherence to QCIs in S. Aureus bloodstream infection did not reach expected rates. Apart from the benefits of application as a bundle, focus control and adequate targeted therapy were independently associated with low mortality. Escrihuela-Vidal F, Kaasch AJ, Von Cube M, Rieg S, Kern W V, Seifert H, et al. Impact of adherence to individual quality-of-care indicators on the prognosis of bloodstream infection due to Staphylococcus aureus: a prospective observational multicentre cohort. Clin Microbiol Infect Off Publ Eur Soc Clin Microbiol Infect Dis. 2022 Oct; 10.1016/j.cmi.2022.10.019 1469-0691 Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases https://hdl.handle.net/20.500.13003/18860 36283610 L2021159185 2-s2.0-85141779057 https://hdl.handle.net/20.500.12105/23682 996484100001 Impact of adherence to individual quality-of-care indicators on the prognosis of bloodstream infection due to Staphylococcus aureus: a prospective observational multicentre cohort