Adherence to and clinical utility of “Quality Indicators” for Staphylococcus aureus bacteremia; a retrospective, multicenter study

Abstract

Background We aimed to improve the prognosis, treatment, and management of Staphylococcus aureus bacteremia (SAB) by evaluating the background and adherence to quality indicators (QIs) in patients with SAB. Methods We retrospectively collected clinical and microbiological data on hospitalized patients with SAB from 14 hospitals (three with > 600, two with 401–600, five with 201–400, and four with ≤ 200 beds) in Japan from January–December 2022. SAB management quality was evaluated by SAB-QI score (ranging 0–13 points) which consisted of thirteen QIs (grouped into five categories) based on previous literature. Results Of 4,448 positive blood culture episodes, 289 SAB cases (6.5%) were enrolled. SAB-QI score ranged 3–13, with a median of 9 points. The SAB-QI score was the highest in middle-sized hospitals with 401–600 beds. Adherences to each of four QI categories (Blood cultures, Echocardiography, Source control, and Antibiotic treatment) were significantly higher in survived cases than in fatal cases. Kaplan–Meier curves with log-rank tests demonstrated that higher adherence to SAB-QIs indicates a better prognosis. Conclusions Our study highlights that greater adherence to SAB-QIs correlates with improved patient outcomes. Management of patients with SAB should follow these recommended indicators to keep the quality of care.