Routine Evidence-Based Care for S aureus Infection Improves Survival

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Analyses included 36,868 patients in 124 Veterans Health Administration hospitals with infection resulting from methicillin-resistant S aureus and methicillin-susceptible S aureus.
Analyses included 36,868 patients in 124 Veterans Health Administration hospitals with infection resulting from methicillin-resistant S aureus and methicillin-susceptible S aureus.

A new study published in JAMA Internal Medicine confirms that using evidence-based care to treat Staphylococcus aureus improves patient outcomes and demonstrates that increasing the use of these practices can further reduce deaths among hospitalized patients.

S aureus is a known common risk for hospital patients, leading to poor outcomes, including death. Antibiotics, use of echocardiography to identify patients with endocarditis, and consulting infectious disease specialists as needed are treatments proven effective for S aureus. But it has not been known whether there has been any increase in routine use of this evidence-based care for treatment of S aureus, nor whether routine use of evidence-based care does indeed improve overall survival rates.

For the study, researchers at Iowa City Veterans Affairs Health Care System and colleagues looked at all-cause 30-day mortality risk for 36,868 patients infected with the bacterium who were treated at 124 Veterans Health Administration hospitals around the country from 2003 through 2014.

They found that deaths associated with S aureus decreased significantly during the period studied, going from 23.5% (95% CI, 23.3%-23.8%) in 2003 to 18.2% (95% CI, 17.9%-18.5%) in 2014. Concurrently, the number of patients who received evidence-based care increased from 66.4% (n=2467) to 78.9% (n=1991) for antibiotics use, from 33.8% (n=1256) to 72.8% (n=1837) for echocardiography, and from 37.4% (n=1390) to 68.0% (n=1717) for consultations with infectious diseases specialists.

On the basis of these positive results just at Veterans Health Administration hospitals, the researchers conclude that increasing routine use of evidence-based care for S aureus infection has great potential for further improving survival among patients in healthcare settings.

Reference

Goto M, Schweizer ML, Vaughn-Sarrazin MS, et al. Association of evidence-based care processes with mortality in Staphylococcus aureus bacteremia at veterans health administration hospitals, 2003-2014 [published online September 5, 2017]. JAMA Intern Med. doi: 10.1001/jamainternationalmed.2017.3958

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