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Volume 38, Issue 2

Original Article

The Impact of Implementing a Minimum Evaluation Bundle on Clinical Outcomes in the Management of Patients with Staphylococcus aureus Bacteremia

Muammer Çelik
Affiliations
  • Dokuz Eylül Üniversitesi Tıp Fakültesi, İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, İzmir, Türkiye
https://orcid.org/0000-0001-6190-5370
,
Adnan Karabacak
Affiliations
  • Dokuz Eylül Üniversitesi Tıp Fakültesi, İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, İzmir, Türkiye
https://orcid.org/0000-0002-7252-3885
,
Nazlı Arzu
Affiliations
  • Dokuz Eylül Üniversitesi Tıp Fakültesi, İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, İzmir, Türkiye
https://orcid.org/0000-0001-8859-6432
,
Mahmut Cem Ergon
Affiliations
  • Dokuz Eylül Üniversitesi Tıp Fakültesi, Tıbbi Mikrobiyoloji Anabilim Dalı, İzmir, Türkiye
https://orcid.org/0000-0002-4847-987X
,
Vildan Avkan-Oğuz
Affiliations
  • Dokuz Eylül Üniversitesi Tıp Fakültesi, İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, İzmir, Türkiye
https://orcid.org/0000-0001-7648-7730
  • bacteremia
  • management
  • minimum değerlendirme demeti
  • minimum evaluation bundle
  • Staphylococcus aureus
  • Staphylococcus aureus
  • yönetim

Abstract

Objective: Staphylococcus aureus bacteremia (SAB) is a significant global cause of mortality and a growing concern due to increasing antimicrobial resistance. This study aimed to evaluate the clinical features, methicillin resistance rates, and the impact of implementing a “minimum evaluation bundle” on clinical outcomes in the management of SAB.

Methods: This retrospective, single-center study included adult patients hospitalized for SAB between 2018 and 2021. Demographic data, clinical and laboratory findings, antimicrobial susceptibility results, and mortality rates were retrieved from medical records. Complete adherence to the minimum evaluation bundle in SAB management was defined as obtaining an infectious diseases (ID) consultation, performing echocardiography, and collecting follow-up blood cultures.

Results: A total of 260 patients were enrolled in the study. The median age was 67 years (IQR: 57–80), with 55.4% of patients aged 65 years or older. Hypertension (46.2%), diabetes mellitus (30%), and chronic heart disease (26.2%) were the most common comorbidities. Primary SAB was identified in 45.8% of patients. Methicillin resistance was detected in 17.3% of S. aureus isolates. Complete adherence to the minimum evaluation bundle occurred in 38.5% of cases. Follow-up blood cultures, ID consultation, and echocardiography were performed in 79.6%, 69.2%, and 45.8% of cases, respectively. Overall mortality was 33.8%. Advanced age (≥65 years) (OR: 2.878; p=0.002), presence of malignancy (OR: 2.952; p=0.010), and intensive care unit (ICU) admission (OR: 13.527; p<0.001) were identified as independent risk factors for mortality. Adherence to the minimum evaluation bundle was significantly associated with lower mortality (OR: 0.489; p=0.041).

Conclusion: SAB is associated with a high risk of mortality, particularly in elderly patients, those with malignancy, and ICU admissions. Complete adherence to the recommended minimum evaluation bundle may improve survival. These findings underscore the need for standardized management protocols and strategies to enhance compliance, which prospective multicenter studies should support.

Show References

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  • 97-102
  • Muammer Çelik
  • [email protected]
  • 10.36519/kd.2025.5177
  • December 13, 2024
  • June 8, 2025
  • June 28, 2025

  • Çelik M, Karabacak A, Arzu N, Ergon MC, Avkan-Oğuz V. [The impact of implementing a minimum evaluation bundle on clinical outcomes in the management of patients with Staphylococcus aureus bacteremia]. Klimik Derg. 2025;38(2):97-102. Turkish.

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