Impact of a multidisciplinary management team on clinical outcome in ICU patients affected by Gram-negative bloodstream infections: a pre-post quasi-experimental study
Authors' conclusion
The institution of a MMT allowed for an optimization of antimicrobial treatments, reflecting to a significant decrease in new MDRO colonization and microbiological failure among critically ill patients.
Study context
- Population
- Critically ill ICU patients with Gram-negative bloodstream infection
- Participants
- 135 patients
- Comparison
- Post-intervention vs Pre-intervention
- Post-interventionn = 68
- Pre-interventionn = 67reference
- Outcome
- Microbiological failure and new-onset 30-day MDRO colonization
- Follow-up
- 30 days
Main finding
As reported in the abstract
Microbiological failure, post-phase vs pre-phase
10.3% vs. 29.9%
p = 0.005
New-onset 30-day multidrug-resistant organisms (MDRO) colonization, post-phase vs pre-phase
8.3% vs. 36.6%
p < 0.001
Multidisciplinary management team (MMT) protective for new MDRO colonization (multivariable OR, 95%CI)
OR 0.17, 95%CI
0.05–0.67
MMT protective for microbiological failure (multivariable OR, 95%CI)
OR 0.37, 95%CI
0.14–0.98
Further findings
Empirical carbapenem administration
- Decreased significantly in the post-phase
- 40.3% vs. 62.7%, p = 0.02
Appropriate empirical therapy
- Increased in the post-phase
- 86.9% vs. 55.2%, p < 0.001
Overall antibiotic treatment duration
- Decreased in the post-phase (days)
- 12 vs. 16 days, p < 0.001
Delta SOFA and all-cause 30-day mortality
- No differences
Original publication
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