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. 2009 Sep;88(5):263-267.
doi: 10.1097/MD.0b013e3181b8fccb.

Infectious diseases consultation lowers mortality from Staphylococcus aureus bacteremia

Timothy Lahey  1 , Ruta Shah, Jennifer Gittzus, Joseph Schwartzman, Kathryn Kirkland
Affiliations

Infectious diseases consultation lowers mortality from Staphylococcus aureus bacteremia

Timothy Lahey et al. Medicine (Baltimore). 2009 Sep.

Abstract

Staphylococcus aureus bacteremia (SAB) is a lethal and increasingly common infection in hospitalized patients. We assessed the impact of infectious diseases consultation (IDC) on clinical management and hospital mortality of SAB in 240 hospitalized patients in a retrospective cohort study. Patients who received IDC were older than those who did not (57.9 vs. 51.7 yr; p = 0.05), and were more likely to have a health care-associated infection (63% vs. 45%; p < 0.01). In patients who received IDC, there was a higher prevalence of severe complications of SAB such as central nervous system involvement (5% vs. 0%, p = 0.01), endocarditis (20% vs. 2%; p < 0.01), or osteomyelitis (15.6% vs. 3.4%; p < 0.01). Patients who received IDC had closer blood culture follow-up and better antibiotic selection, and were more likely to have pus or prosthetic material removed. Hospital mortality from SAB was lower in patients who received IDC than in those who did not (13.9% vs. 23.7%; p = 0.05). In multivariate survival analysis, IDC was associated with substantially lower hazard of hospital mortality during SAB (hazard 0.46; p = 0.03). This mortality benefit accrued predominantly in patients with methicillin-resistant SAB (hazard 0.3; p < 0.01), and in patients who did not require ICU admission (hazard 0.15; p = 0.01). In conclusion, IDC is associated with reduced mortality in patients with staphylococcal bacteremia.

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Figures

FIGURE 1
FIGURE 1
Impact of infectious diseases consultation on the clinical management of Staphylococcus aureus bacteremia. Patients with infectious diseases consultation (IDC, black bars) were more likely to receive correct antibiotic therapy, have follow-up blood cultures, and to have an intervention aimed at draining pus or removing a prosthesis than patients who did not receive IDC (white bars).
FIGURE 2
FIGURE 2
Survival of patients who did (dotted line) or did not (solid line) receive infectious diseases consultation during Staphylococcus aureus bacteremia.
See this image and copyright information in PMC

References

    1. Byl B, Clevenbergh P, Jacobs F, Struelens MJ, Zech F, Kentos A, Thys JP. Impact of infectious diseases specialists and microbiological data on the appropriateness of antimicrobial therapy for bacteremia. Clin Infect Dis. 1999;29:60–66. discussion 67–68. - PubMed
    1. Chang FY, MacDonald BB, Peacock JE, Jr, Musher DM, Triplett P, Mylotte JM, O’Donnell A, Wagener MM, Yu VL. A prospective multicenter study of Staphylococcus aureus bacteremia: incidence of endocarditis, risk factors for mortality, and clinical impact of methicillin resistance. Medicine (Baltimore) 2003;82:322–332. - PubMed
    1. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–383. - PubMed
    1. Cosgrove SE, Fowler VG., Jr Management of methicillin-resistant Staphylococcus aureus bacteremia. Clin Infect Dis. 2008;46(suppl 5):S386–S393. - PubMed
    1. Cosgrove SE, Sakoulas G, Perencevich EN, Schwaber MJ, Karchmer AW, Carmeli Y. Comparison of mortality associated with methicillin-resistant and methicillin-susceptible Staphylococcus aureus bacteremia: a meta-analysis. Clin Infect Dis. 2003;36:53–59. - PubMed

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