Optimizing the Management of Staphylococcus Aureus Bacteremia (OPTIMUS-SAB)

May 7, 2026 updated by: University of Alberta

Optimizing the Management of Staphylococcus Aureus Bacteremia (OPTIMUS-SAB): A Stepped Wedge Clinical Trial Evaluating the Effectiveness of a Centralized S. Aureus Management Model

Staphylococcus aureus bacteremia (SAB) is associated with high morbidity and mortality rates with an incidence disproportionately higher in vulnerable populations. Management according to evidence-based care parameters, in particular Infectious Diseases (ID) consultation, is associated with improved mortality. SAB management is suboptimal in Alberta compared to other jurisdictions. An Alberta-based pilot study confirmed that timely recommendations to optimize SAB care, including ID consultation, was associated with improved adherence to all evidence-based quality-of-care indicators.

Leveraging this pilot work, the investigators aim to implement OPTIMUS-SAB, an enhanced model of the pilot, to optimize and standardize SAB management across Alberta. The implementation study will be a zone-based acute care site stepped wedge design. OPTIMUS-SAB will consist of a centralized SAB care team whom will receive automated notification of all blood cultures positive for S. aureus allowing them to review the patient's medical chart and make preliminary management recommendations according to an evidence-based care bundle.

The investigators will evaluate adherence to evidence-based SAB quality-of-care indicators before and after OPTIMUS-SAB implementation and expect this to improve with a resultant reduction in duration of bacteremia, length of stay, readmission rates, and mortality. In turn, this will translate into cost savings for the health care system.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

2542

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Canada
    • Alberta
      • Athabasca, Alberta, Canada
        • Athabasca Healthcare Centre
      • Banff, Alberta, Canada
        • Mineral Springs Hospital
      • Barrhead, Alberta, Canada
        • Barrhead Healthcare Centre
      • Bassano, Alberta, Canada
        • Bassano Health Centre
      • Beaverlodge, Alberta, Canada
        • Beaverlodge Municipal Hospital
      • Black Diamond, Alberta, Canada
        • Oilfields General Hospital
      • Bonnyville, Alberta, Canada
        • Bonnyville Healthcare Centre
      • Bow Island, Alberta, Canada
        • Bow Island Health Centre
      • Boyle, Alberta, Canada
        • Boyle Healthcare Centre
      • Brooks, Alberta, Canada
        • Brooks Health Centre
      • Calgary, Alberta, Canada
        • Foothills Medical Centre
      • Calgary, Alberta, Canada
        • Tom Baker Cancer Centre
      • Calgary, Alberta, Canada
        • South Health Campus
      • Calgary, Alberta, Canada
        • Peter Lougheed Centre
      • Calgary, Alberta, Canada
        • Arthur J.E. Child Comprehensive Cancer Centre
      • Camrose, Alberta, Canada
        • St. Mary's Hospital
      • Canmore, Alberta, Canada
        • Canmore General Hospital
      • Cardston, Alberta, Canada
        • Cardston Health Centre
      • Castor, Alberta, Canada
        • Our Lady of the Rosary Hospital
      • Claresholm, Alberta, Canada
        • Claresholm General Hospital
      • Coaldale, Alberta, Canada
        • Coaldale Health Centre
      • Cold Lake, Alberta, Canada
        • Cold Lake Healthcare Centre
      • Consort, Alberta, Canada
        • Consort Hospital and Care Centre
      • Coronation, Alberta, Canada
        • Coronation Hospital and Care Centre
      • Crowsnest Pass, Alberta, Canada
        • Crowsnest Pass Health Centre
      • Daysland, Alberta, Canada
        • Daysland Health Centre
      • Devon, Alberta, Canada
        • Devon General Hospital
      • Didsbury, Alberta, Canada
        • Didsbury District Health Services
      • Drayton Valley, Alberta, Canada
        • Drayton Valley Hospital and Care Centre
      • Drumheller, Alberta, Canada
        • Drumheller Health Centre
      • Edmonton, Alberta, Canada
        • Royal Alexandra Hospital
      • Edmonton, Alberta, Canada
        • University of Alberta Hospital
      • Edmonton, Alberta, Canada
        • Cross Cancer Institute
      • Edmonton, Alberta, Canada
        • Grey Nuns Community Hospital
      • Edmonton, Alberta, Canada
        • Glenrose Rehabilitation Hospital
      • Edmonton, Alberta, Canada
        • Misericordia Community Hospital
      • Edson, Alberta, Canada
        • Edson Healthcare Centre
      • Elk Point, Alberta, Canada
        • Elk Point Healthcare Centre
      • Fairview, Alberta, Canada
        • Fairview Health Complex
      • Fort McMurray, Alberta, Canada
        • Northern Lights Regional Health Centre
      • Fort Vermilion, Alberta, Canada
        • St. Theresa General Hospital
      • Fox Creek, Alberta, Canada
        • Fox Creek Healthcare Centre
      • Ft Saskatchewan, Alberta, Canada
        • Fort Saskatchewan Community Hospital
      • Grande Cache, Alberta, Canada
        • Grande Cache Community Health Complex
      • Grande Prairie, Alberta, Canada
        • Grande Prairie Regional Hospital
      • Grimshaw, Alberta, Canada
        • Grimshaw / Berwyn and District Community Health Centre
      • Hanna, Alberta, Canada
        • Hanna Health Centre
      • Hardisty, Alberta, Canada
        • Hardisty Health Centre
      • High Level, Alberta, Canada
        • Northwest Health Centre
      • High Prairie, Alberta, Canada
        • High Prairie Health Complex
      • High River, Alberta, Canada
        • High River General Hospital
      • Hinton, Alberta, Canada
        • Hinton Healthcare Centre
      • Innisfail, Alberta, Canada
        • Innisfail Health Centre
      • Jasper, Alberta, Canada
        • Seton - Jasper Healthcare Centre
      • Killam, Alberta, Canada
        • Killam Health Centre
      • Lac La Biche, Alberta, Canada
        • William J Cadzow - Lac La Biche Health Care Centre
      • Lacombe, Alberta, Canada
        • Lacombe Hospital
      • Lamont, Alberta, Canada
        • Lamont Health Centre
      • Leduc, Alberta, Canada
        • Leduc Community Hospital
      • Lethbridge, Alberta, Canada
        • Chinook Regional Hospital
      • Lloydminster, Alberta, Canada
        • Lloydminster Hospital
      • Manning, Alberta, Canada
        • Manning Community Health Centre
      • Mayerthorpe, Alberta, Canada
        • Mayerthorpe Healthcare Centre
      • McLennan, Alberta, Canada
        • Sacred Heart Community Healt
      • Medicine Hat, Alberta, Canada
        • Medicine Hat Regional Hospital
      • Olds, Alberta, Canada
        • Olds Hospital and Care Centre
      • Oyen, Alberta, Canada
        • Big Country Hospital
      • Peace River, Alberta, Canada
        • Peace River Community Health Centre
      • Pincher Creek, Alberta, Canada
        • Pincher Creek Health Centre
      • Ponoka, Alberta, Canada
        • Ponoka Hospital
      • Provost, Alberta, Canada
        • Provost Health Centre
      • Raymond, Alberta, Canada
        • Raymond Health Centre
      • Red Deer, Alberta, Canada
        • Red Deer Regional Hospital Centre
      • Redwater, Alberta, Canada
        • Redwater Health Centre
      • Rimbey, Alberta, Canada
        • Rimbey Hospital
      • Rocky Mountain House, Alberta, Canada
        • Rocky Mountain House Health Centre
      • Rockyview, Alberta, Canada
        • Rockyview General Hospital
      • Slave Lake, Alberta, Canada
        • Slave Lake Healthcare Centre
      • Smoky Lake, Alberta, Canada
        • George McDougall - Smoky Lake Healthcare Centre
      • Spirit River, Alberta, Canada
        • Central Peace Health Complex
      • St. Albert, Alberta, Canada
        • Sturgeon Community Hospital
      • St. Paul, Alberta, Canada
        • St. Therese - St. Paul Healthcare Centre
      • Stettler, Alberta, Canada
        • Stettler Hospital
      • Strathmore, Alberta, Canada
        • Strathmore District Health Services
      • Sundre, Alberta, Canada
        • Myron Thompson Health Centre
      • Swan Hills, Alberta, Canada
        • Swan Hills Healthcare Centre
      • Taber, Alberta, Canada
        • Taber Health Centre
      • Three Hills, Alberta, Canada
        • Three Hills Health Centre
      • Tofield, Alberta, Canada
        • Tofield Health Centre
      • Two Hills, Alberta, Canada
        • Two Hills Health Centre
      • Valleyview, Alberta, Canada
        • Valleyview Health Centre
      • Vegreville, Alberta, Canada
        • St. Joseph's General Hospital
      • Vermilion, Alberta, Canada
        • Vermilion Health Centre
      • Viking, Alberta, Canada
        • Viking Health Centre
      • Vulcan, Alberta, Canada
        • Vulcan Community Health Centre
      • Wabasca, Alberta, Canada
        • Wabasca/Desmarais Healthcare Centre
      • Wainwright, Alberta, Canada
        • Wainwright Health Centre
      • Westlock, Alberta, Canada
        • Westlock Healthcare Centre
      • Westview Village, Alberta, Canada
        • Westview Health Centre
      • Wetaskiwin, Alberta, Canada
        • Wetaskiwin Hospital
      • Whitecourt, Alberta, Canada
        • Whitecourt Healthcare Centre

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Age greater than 18 years at the time of hospital admission
  • Confirmed S. aureus bacteremia by blood culture performed at a laboratory in Alberta, Canada
  • Admitted to a designated acute care site in Alberta, Canada

Exclusion Criteria:

  • The treating team believes death is imminent or inevitable .
  • GCD are C-level within 48 hours of admission.
  • The patient is transferred in from an out-of-province acute care center with a pre-existing SAB diagnosis.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: Non-Randomized
  • Interventional Model: Sequential Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
No Intervention: Standard of care
Experimental: OPTIMUS-SAB care pathway
Province-wide real time automated notifications of new SAB cases will be established and delivered to a centralized SAB care team electronically through Connect Care. The centralized SAB care team consists of a SAB clinical coordinator, ID specialists and other ad hoc representation depending on patient needs. Following patient chart review, the centralized SAB care team contacts the most responsible physician (MRP) to provide preliminary recommendations to optimize care, both verbally and in written format, facilitated by Connect Care (Alberta Health Services electronic medical record).
Other: OPTIMUS-SAB clinical care pathway
Activation of SAB clinical care pathway within EMR system.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Adherence to quality-of-care indicators
Time Frame: Within 90 days

Defined as:

  1. ID involvement and time to ID involvement, defined by the presence of an ID consult note and/or recommendations in the chart.
  2. Repeat blood cultures, to document clearance of bacteremia, within 72 hours from the last positive blood culture.
  3. Guideline-concordant empiric antibiotic administered and time to receipt.
  4. Guideline concordant definitive antibiotic administered and time to receipt.
  5. Therapeutic drug monitoring of patents treatments with vancomycin.
  6. Appropriate dose adjustment of antimicrobials based on renal function according to local guidelines.
  7. Echocardiogram (transthoracic or transesophageal) performed within 72 hours of diagnosis.
  8. Source control achieved.
  9. Appropriate duration of antibiotic therapy ordered and delivered.
Within 90 days

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Length of stay
Time Frame: 180 days maximum
Acute hospital length of stay
180 days maximum
Hospital re-admission rates
Time Frame: 90 days
re-admission to acute care rate
90 days
All-cause mortality
Time Frame: 180 days
death from any cause
180 days
In hospital mortality
Time Frame: 90 days
death within hospital stay
90 days
Costing evaluation
Time Frame: One year
Cost of SAB treatment related to hospitalization, including physician provision of care, and antibiotics.
One year
Implementation evaluation
Time Frame: 3 years
User experience and feedback from patients and providers will be collected at the start and end of each active implementation phase. This information will be paired with assessments of barriers, facilitators, and contextual factors informed by the Consolidated Framework for Implementation Research (CFIR) and Normalization Process Theory during the pre-implementation phase and at the end of active implementation.
3 years

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Alberta

Collaborators

Alberta Health services

Investigators

  • Principal Investigator: Justin Chen, MD, University of Alberta

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 1, 2024

Primary Completion (Actual)

October 31, 2025

Study Completion (Actual)

April 30, 2026

Study Registration Dates

First Submitted

March 23, 2024

First Submitted That Met QC Criteria

March 23, 2024

First Posted (Actual)

March 29, 2024

Study Record Updates

Last Update Posted (Actual)

May 12, 2026

Last Update Submitted That Met QC Criteria

May 7, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Pro00128904

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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