TY - JOUR
T1 - Global Differences in the Management of Staphylococcus aureus Bacteremia
T2 - No International Standard of Care
AU - Westgeest, Annette C
AU - Buis, David T P
AU - Sigaloff, Kim C E
AU - Ruffin, Felicia
AU - Visser, Leo G
AU - Yu, Yunsong
AU - Schippers, Emile F
AU - Lambregts, Merel M C
AU - Tong, Steven Y C
AU - de Boer, Mark G J
AU - Fowler, Vance G
N1 - Funding Information: Financial support. Work contained in this manuscript was made possible by grant number 1R01-AI165671 (V. G. F.) from the National Institutes of Health (NIH). Publisher Copyright: © 2023 The Author(s). Published by Oxford University Press on behalf of Infectious Diseases Society of America.
PY - 2023/10/15
Y1 - 2023/10/15
N2 - Background: Despite being the leading cause of mortality from bloodstream infections worldwide, little is known about regional variation in treatment practices for Staphylococcus aureus bacteremia (SAB). The aim of this study was to identify global variation in management, diagnostics, and definitions of SAB. Methods: During a 20-day period in 2022, physicians throughout the world were surveyed on SAB treatment practices. The survey was distributed through listservs, e-mails, and social media. Results: In total, 2031 physicians from 71 different countries on 6 continents (North America [701, 35%], Europe [573, 28%], Asia [409, 20%], Oceania [182, 9%], South America [124, 6%], and Africa [42, 2%]) completed the survey. Management-based responses differed significantly by continent for preferred treatment of methicillin-susceptible S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA) bacteremia, use of adjunctive rifampin for prosthetic material infection, and use of oral antibiotics (P <. 01 for all comparisons). The 18F-FDG PET/CT scans were most commonly used in Europe (94%) and least frequently used in Africa (13%) and North America (51%; P <. 01). Although most respondents defined persistent SAB as 3-4 days of positive blood cultures, responses ranged from 2 days in 31% of European respondents to 7 days in 38% of Asian respondents (P <. 01). Conclusions: Large practice variations for SAB exist throughout the world, reflecting the paucity of high-quality data and the absence of an international standard of care for the management of SAB.
AB - Background: Despite being the leading cause of mortality from bloodstream infections worldwide, little is known about regional variation in treatment practices for Staphylococcus aureus bacteremia (SAB). The aim of this study was to identify global variation in management, diagnostics, and definitions of SAB. Methods: During a 20-day period in 2022, physicians throughout the world were surveyed on SAB treatment practices. The survey was distributed through listservs, e-mails, and social media. Results: In total, 2031 physicians from 71 different countries on 6 continents (North America [701, 35%], Europe [573, 28%], Asia [409, 20%], Oceania [182, 9%], South America [124, 6%], and Africa [42, 2%]) completed the survey. Management-based responses differed significantly by continent for preferred treatment of methicillin-susceptible S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA) bacteremia, use of adjunctive rifampin for prosthetic material infection, and use of oral antibiotics (P <. 01 for all comparisons). The 18F-FDG PET/CT scans were most commonly used in Europe (94%) and least frequently used in Africa (13%) and North America (51%; P <. 01). Although most respondents defined persistent SAB as 3-4 days of positive blood cultures, responses ranged from 2 days in 31% of European respondents to 7 days in 38% of Asian respondents (P <. 01). Conclusions: Large practice variations for SAB exist throughout the world, reflecting the paucity of high-quality data and the absence of an international standard of care for the management of SAB.
KW - Staphylococcus aureus bacteremia
KW - global survey
KW - practice patterns
UR - http://www.scopus.com/inward/record.url?scp=85168353900&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/cid/ciad363
DO - https://doi.org/10.1093/cid/ciad363
M3 - Article
C2 - 37310693
SN - 1058-4838
VL - 77
SP - 1092
EP - 1101
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 8
ER -