{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T19:47:12Z","timestamp":1790279232212,"version":"4.1.0"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2019,12,9]],"date-time":"2019-12-09T00:00:00Z","timestamp":1575849600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Spanish Ministry of Economy and Competitiveness, Instituto de Salud Carlos III","award":["FIS PI15\/00744"],"award-info":[{"award-number":["FIS PI15\/00744"]}]},{"name":"European Development Regional Fund"},{"name":"Europe\u2019 ERDF, Spanish Network for the Research","award":["REIPI RD06\/0008"],"award-info":[{"award-number":["REIPI RD06\/0008"]}]},{"name":"Europe\u2019 ERDF, Spanish Network for the Research","award":["2017SGR1432"],"award-info":[{"award-number":["2017SGR1432"]}]},{"name":"Catalan Health Agency"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Candidaemia is a leading cause of bloodstream infections in hospitalized patients all over the world. It remains associated with high mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess the impact of implementing an evidence-based package of measures (bundle) on the quality of care and outcomes of candidaemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review of the literature was performed to identify measures related to better outcomes in candidaemia. Eight quality-of-care indicators (QCIs) were identified and a set of written recommendations (early treatment, echinocandins in septic shock, source control, follow-up blood culture, ophthalmoscopy, echocardiography, de-escalation, length of treatment) was prospectively implemented. The study was performed in 11 tertiary hospitals in Spain. A quasi-experimental design before and during bundle implementation (September 2016 to February 2018) was used. For the pre-intervention period, data from the prospective national surveillance were used (May 2010 to April 2011).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 385 and 263 episodes were included in the pre-intervention and intervention groups, respectively. Adherence to all QCIs improved in the intervention group. The intervention group had a decrease in early (OR 0.46; 95% CI 0.23\u20130.89; P\u2009=\u20090.022) and overall (OR 0.61; 95% CI 0.4\u20130.94; P\u2009=\u20090.023) mortality after controlling for potential confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Implementing a structured, evidence-based intervention bundle significantly improved patient care and early and overall mortality in patients with candidaemia. Institutions should embrace this objective strategy and use the bundle as a means to measure high-quality medical care of patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkz491","type":"journal-article","created":{"date-parts":[[2019,11,20]],"date-time":"2019-11-20T15:10:05Z","timestamp":1574262605000},"page":"730-737","source":"Crossref","is-referenced-by-count":28,"title":["An evidence-based bundle improves the quality of care and outcomes of patients with candidaemia"],"prefix":"10.1093","volume":"75","author":[{"given":"Celia","family":"Cardozo","sequence":"first","affiliation":[{"name":"Hospital Cl\u00ednic, IDIBAPS (Institut d\u2019Investigacions biom\u00e8diques Agust Pi i Sunyer), Universitat de Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo","family":"Cuervo","sequence":"first","affiliation":[{"name":"Hospital Universitari de Bellvitge, IDIBELL (Institut D\u2019Investigaci\u00f3 Biom\u00e8dica de 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