Close cooperation between infectious disease physicians and attending physicians results in better outcomes for patients with Staphylococcus aureus bacteraemia.
Clin Microbiol Infect. 2009 Dec 29;
Authors: Nagao M, Iinuma Y, Saito T, Matsumura Y, Shirano M, Matsushima A, Takakura S, Ito Y, Ichiyama S
Abstract Staphylococcus aureus bacteraemia (SAB) is a serious infection that demands prompt clinical attention for good outcome. To assess the impact of intervention by infectious diseases physicians (IDPs) in cases with SAB, a retrospective cohort study of patients with SAB, comparing the management and outcome of patients during the initial and the later half of the intervention period, was performed in a 1240-bed, university hospital in Japan. Three hundred and forty six patients with SAB during 7-year period, from 2002 to 2008, were included, and 194 patients in the initial half of the period (from 2002 to 2005) were compared with 152 patients in the later period (from 2006 to 2008). No significant difference was seen between the 2 groups in patient's clinical background. The proportion of methicillin resistant S. aureus was lower during the later period (56.2% vs. 43.3%; P=.02). Echocardiography was used more frequently (37.1% vs. 64.5%; P=.00). Infective endocarditis and metastatic infections were diagnosed more frequently (10.8% vs. 20.4%; P=.00). Follow-up blood cultures were obtained more regularly (52.1% vs. 73.7%; P=.00) and therapy was more frequently administered for at least 14 days (47.4% vs. 82.2%; P=.00). The 30-day mortality improved during the intervention period (25.8% vs. 16.4%; P=.04). The number of blood cultures increased annually and the number of consultations increased about 1.6 fold compared with 2002. Proactive intervention by IDPs raised awareness of optimal management of bacteraemia and improved the adherence to the standards of care, which subsequently resulted in the improvement of the outcome.
PMID: 20047606 [PubMed - as supplied by publisher]