• Rossana Rosa, Andrew Wawrzyniak, Maroun Sfeir, Laura Smith, and Lilian M Abbo.
• Department of Medicine, Jackson Memorial Hospital, Miami, Florida.
• J Hosp Med. 2016 Jan 1; 11 (1): 27-32.

BackgroundStaphylococcus aureus bacteremia (SAB) is associated with significant morbidity and mortality in hospitalized adults.ObjectiveWe aimed to identify current practice patterns in the management of SAB, and to evaluate their association with clinical outcomes.DesignRetrospective cohort study.SettingA 1558-bed tertiary care teaching hospital.PatientsAdult patients hospitalized between January 1, 2012 through April 30, 2013, who had at least 1 positive blood culture with S aureus.InterventionNoneMeasurementsElectronic medical records were reviewed and the processes of care in the management of SAB were identified. The main outcome was clinical failure, defined as a composite endpoint of in-hospital mortality and persistent bacteremia.ResultsTwo hundred fifty episodes of SAB occurred in 241 patients, and 78 (32.4%) had clinical failure. Processes of care that impacted the risk of clinical failure included: timing of follow-up blood cultures (delays of >4 days had a relative risk [RR] of 6.6; 95% confidence interval [CI]: 2.1-20.5; P = 0.001), consultation with infectious diseases specialist within 6 days from diagnosis of SAB (RR: 0.3; 95% CI: 0.1-0.9; P = 0.03), and use of β-lactams in patients with methicillin-susceptible S aureus bacteremia (RR: 0.1; 95% CI: 0.04-0.5; P = 0.002).ConclusionsThe processes of care identified in our study could serve as quality and patient safety indicators for the management of SAB.© 2015 Society of Hospital Medicine.

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