Clinical effect of a multidisciplinary team approach to the initial treatment of patients with hospital-acquired bloodstream infections at a Japanese university hospital.
BACKGROUND
Hospital-acquired bloodstream infections (BSIs) are significant causes of mortality, and strategies to improve outcomes are needed. We aimed to evaluate the clinical efficacy of a multidisciplinary infection control team (ICT) approach to the initial treatment of patients with hospital-acquired BSI.


METHODS
A before-after quasiexperimental study of patients with hospital-acquired BSI was performed in a Japanese university hospital. The ICT provided immediate recommendations to the attending physician about appropriate antimicrobial therapy and management after reviewing blood cultures, Gram's stain, final organism, and antimicrobial susceptibility results.


RESULTS
The sample included 469 patients with hospital-acquired BSI (n = 210, preintervention group; n = 259, postintervention group). There were no significant differences between the groups in background or microbiologic characteristics. The 30-day mortality was significantly lower and significantly more patients received appropriate antimicrobial therapy in the postintervention group (22.9% vs 14.3%; P = .02 and 86.5% vs 69.0%; P < .001, respectively). Multivariate analysis confirmed that the ICT intervention was significantly associated with appropriate antimicrobial therapy (odds ratio, 2.22; 95% confidence interval, 1.27-3.89) and 30-day mortality (odds ratio, 0.49; 95% confidence interval, 0.25-0.95).


CONCLUSIONS
A timely multidisciplinary team approach decreases the delay of appropriate antimicrobial treatment and may improve HABSI patient outcomes.
['Tsukamoto|Hitoshi|H|', 'Higashi|Takashi|T|', 'Nakamura|Toshiaki|T|', 'Yano|Ryoichi|R|', 'Hida|Yukio|Y|', 'Muroi|Yoko|Y|', 'Ikegaya|Satoshi|S|', 'Iwasaki|Hiromichi|H|', 'Masada|Mikio|M|']
D000368:Aged D000900:Anti-Bacterial Agents D016470:Bacteremia D001419:Bacteria D003428:Cross Infection D005260:Female D017052:Hospital Mortality D006785:Hospitals, University D006801:Humans D017053:Infection Control D007362:Intensive Care Units D008297:Male D010348:Patient Care Team
Mortality Infection control team Appropriate antimicrobial therapy