Skip to Main content Skip to Navigation
Journal articles

Management of bloodstream infections by infection specialists: an international ESCMID cross-sectional survey

Abstract : Bloodstream infections (BSIs) are common, however international guidelines are available only for methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia and candidaemia. This international ESCMID cross-sectional survey, open from December 2016 to February 2017, explored the management of BSIs by infection specialists. All infection specialists (senior or trainees) giving at least weekly advice on positive blood cultures could participate. Their practices were evaluated using six clinical vignettes presenting uncomplicated BSI cases. A total of 616 professionals from 56 countries participated [333/616 (54%) infectious diseases specialists, 188/616 (31%) clinical microbiologists], of whom 76% (468/616) were members of an antimicrobial stewardship team. Large variations in practice were noted, in particular for the Escherichia coli, Enterococcus faecalis and Pseudomonas aeruginosa vignettes. Echocardiography was considered standard of care by 81% (373/459) of participants for MRSA, 78% (400/510) for methicillin-susceptible S. aureus and 60% (236/395) for Candida albicans. Antimicrobial combination therapy was recommended by 2% (8/360) of respondents for C. albicans, 11% (43/378) for E. coli, 27% (114/420) for MRSA and 39% (155/393) for E. faecalis. Intravenous-to-oral switch was considered in 68% (285/418) for MRSA, 79% (306/388) for E. faecalis, 72% (264/366) for P. aeruginosa and 75% (270/362) for C. albicans. In multivariable analysis, IDSA guideline-compliant practice was more frequent among participants belonging to an antimicrobial stewardship team (aOR = 1.7, P = 0.018 for the MRSA vignette; and aOR = 2.0, P = 0.008 for the candidaemia vignette). This survey showed large variations in practice among infection specialists. International guidelines on management of BSI are urgently needed.
Document type :
Journal articles
Complete list of metadata

https://hal.univ-lorraine.fr/hal-02353172
Contributor : Sylvie Vialaron <>
Submitted on : Thursday, November 7, 2019 - 11:10:21 AM
Last modification on : Wednesday, March 17, 2021 - 9:54:37 AM

Links full text

Identifiers

Collections

Citation

Kevin Diallo, Nathalie Thilly, Amandine Luc, Guillaume Béraud, Önder Ergonul, et al.. Management of bloodstream infections by infection specialists: an international ESCMID cross-sectional survey. International Journal of Antimicrobial Agents, Elsevier, 2018, 51 (5), pp.794-798. ⟨10.1016/j.ijantimicag.2017.12.010⟩. ⟨hal-02353172⟩

Share

Metrics

Record views

379