Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2016 Mar 1;3(2):ofw048.
doi: 10.1093/ofid/ofw048. eCollection 2016 Mar.

The Impact of Infectious Disease Specialist Consultation for Staphylococcus aureus Bloodstream Infections: A Systematic Review

Julie Paulsen  1 , Erik Solligård  2 , Jan Kristian Damås  3 , Andrew DeWan  4 , Bjørn Olav Åsvold  5 , Michael B Bracken  4
Affiliations
Review

The Impact of Infectious Disease Specialist Consultation for Staphylococcus aureus Bloodstream Infections: A Systematic Review

Julie Paulsen et al. Open Forum Infect Dis. .

Abstract

Staphylococcus aureus is a common cause of severe bloodstream infection. We performed a systematic review to assess whether consultation with infectious disease specialists decreased all-cause mortality or rate of complications of S aureus bloodstream infections. The review also assessed parameters associated with the quality of management of the infection. We searched for eligible studies in PubMed, Embase, Scopus, and clinical trials.gov as well as the references of included studies. We identified 22 observational studies and 1 study protocol for a randomized trial. A meta-analysis was not performed because of the high risk of bias in the included studies. The outcomes are reported in a narrative review. Most included studies reported survival benefit, in the adjusted analysis. Recommended management strategies were carried out significantly more often among patients seen by an infectious disease specialist. Trials, such as cluster-randomized controlled trials, can more validly assess the studies at low risk of bias.

Keywords: Staphylococcus aureus; bloodstream infection; infectious disease specialist consultation.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Literature search flowchart. Abbreviation: SAB, Staphylococcus aureus bloodstream infection.
Figure 2.
Figure 2.
Funnel plot of unadjusted all-cause mortality and recurrence of studies comparing infectious disease consultation (IDC) to no IDC. Abbreviations: OR, odds ratio; SE, standard error.
Figure 3.
Figure 3.
Unadjusted outcome analysis for mortality and recurrence. Abbreviations: CI, confidence interval; IDC, infectious disease consultation.
Figure 4.
Figure 4.
Adjusted outcome analysis for mortality and recurrence. Abbreviations: APS, acute physiology score; CCI, Charlson comorbidity index; CI, confidence interval; ICU, intensive care unit; IDC, infectious disease consultation; MRSA, methicillin-resistant Staphylococcus aureus; SE, standard error.
Figure 5.
Figure 5.
Effect of the intervention on patient management. Abbreviation: CI, confidence interval.
See this image and copyright information in PMC

References

    1. Laupland KB, Church DL, Mucenski M et al. Population-based study of the epidemiology of and the risk factors for invasive Staphylococcus aureus infections. J Infect Dis 2003; 187:1452–9. - PubMed
    1. Laupland KB, Lyytikainen O, Sogaard M et al. The changing epidemiology of Staphylococcus aureus bloodstream infection: a multinational population-based surveillance study. Clin Microbiol Infect 2013; 19:465–71. - PubMed
    1. van Hal SJ, Jensen SO, Vaska VL et al. Predictors of mortality in Staphylococcus aureus bacteremia. Clin Microbiol Rev 2012; 25:362–86. - PMC - PubMed
    1. Lowy FD. Staphylococcus aureus infections. N Engl J Med 1998; 339:520–32. - PubMed
    1. Jacobsson G, Dashti S, Wahlberg T, Andersson R. The epidemiology of and risk factors for invasive Staphylococcus aureus infections in western Sweden. Scand J Infect Dis 2007; 39:6–13. - PubMed