Impact of routine bedside infectious diseases consultation on clinical management and outcome of Staphylococcus aureus bacteraemia in adults.
Clin Microbiol Infect. 2015 May 29;
Authors: Saunderson RB, Gouliouris T, Nickerson EK, Cartwright EJ, Kidney A, Aliyu SH, Brown NM, Limmathurotsakul D, Peacock SJ, Estée Török M
Abstract
Staphylococcus aureus bacteraemia (SAB) is a common, serious infection that is associated with high rates of morbidity and mortality. Evidence suggests that infectious diseases consultation (IDC) improves clinical management in patients with SAB. Here, we examined whether the introduction of a routine bedside IDC service for adults with SAB improved clinical management and outcomes, compared with telephone consultation. We conducted an observational cohort study of 571 adults with SAB at a teaching hospital in the United Kingdom (UK) between July 2006 and December 2012. A telephone consultation was provided on the day of positive blood culture in all cases, but an additional bedside IDC was provided after November 2009 (routine IDC group). Compared with patients in the pre-IDC group, those in the routine IDC group were more likely to have a removable focus of infection identified, echocardiography performed, and follow-up blood cultures taken. They also received longer courses of antimicrobial therapy, were more likely to receive combination antimicrobial therapy, and to have SAB recorded in the hospital discharge summary. There was a trend towards lower mortality at 30 days in the routine IDC group compared to pre-IDC group (12% versus 22%, P=0.07). Our findings suggest that routine bedside IDC should become the standard of care for adults with SAB.
PMID: 26033668 [PubMed - as supplied by publisher]