Evaluation of adherence to an evidence-based bundle of care for the treatment of staphylococcus aureus bacteraemia at Groote Schuur Hospital

Master Thesis


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Background Staphylococcus aureus bacteraemia (SAB) is associated with high hospital mortality. Improvements in outcome have been described with standardised bundles of care. Objectives To study adherence to a standardised bundle of care (BOC) recommendations using a consultation proforma, for all patients admitted with SAB to Groote Schuur hospital over a year. To describe in-hospital and 90-day mortality in these patients Methods A retrospective audit of all unsolicited infectious disease consultations for patients with SAB admitted to Groote Schuur hospital during 2018. Adherence to recommendations of a standard care bundle were audited. Results Eighty six patients were included; 61 (71%) with healthcare-associated infection and 25 (29%) with community associated infection. Over 80% of adherence to treatment recommendations was achieved regarding antibiotic (including vancomycin) usage, source control and use of echocardiography as required. In-hospital mortality was 16% while overall 90-day mortality was 18%, with only age an independent predictor of mortality. No association with adherence to the recommendations and outcome was seen. Conclusion Adherence to a simple BOC is good, when using standardised a proforma as a communication tool. SAB mortality may be reduced by such an approach.