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Formal infectious diseases consultation is associated with decreased mortality in Staphylococcus aureus bacteraemia

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Abstract

To determine the impact of infectious diseases consultation (IDC) in Staphylococcus aureus bacteraemia. All MRSA bacteraemia and a random subset of MSSA bacteraemia were retrospectively analysed. Out of 599 SAB episodes, 162 (27%) were followed by an IDC. Patients with IDC were younger and more frequently intravenous drug users, but fewer resided in a long-term care facility or were indigenous. Hospital length of stay was longer (29.5 vs 17 days, p < 0.001), and endocarditis (19.1% vs 7.3%, p < 0.001) and metastatic seeding (22.2% vs 10.1%, p < 0.001) were more frequent in the IDC group; however, SAPS II scores were lower in the IDC group (27 vs 37, p < 0.001). ICU admission rates in the two groups were similar. The isolate tested susceptible to empirical therapy more frequently in the IDC group (88.9% vs 78.0%, p = 0.003). Seven-day (3.1 vs 16.5%), 30-day (8.0% vs 27.0%) and 1-year mortality (22.2% vs 44.9%) were all lower in the IDC group (all p < 0.001). Multivariate analysis showed that effective initial therapy was the only variable associated with the protective effect of IDC. In patients with SAB, all-cause mortality was significantly lower in patients who had an IDC, because of the higher proportion of patients receiving effective initial antibiotics.

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Acknowledgements

We wish to thank Nicola Hill and Paulette Lee for their assistance in obtaining patient charts.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Microbiology and Infectious Diseases, PathWest Laboratory Medicine Royal Perth Hospital, Wellington Street, Perth, 6000, Western Australia, Australia

    J. O. Robinson, S. Pozzi - Langhi, J. C. Pearson, K. J. Christiansen & G. W. Coombs

  2. Western Australian Institute for Medical Research, Perth, Western Australia, Australia

    M. Phillips

  3. Australian Collaborating Centre for Enterococcus and Staphylococcus Species (ACCESS) Typing and Research, PathWest Laboratory Medicine—WA and Curtin University of Technology, Perth, Western Australia, Australia

    J. O. Robinson, J. C. Pearson, K. J. Christiansen & G. W. Coombs

  4. Department of Microbiology and Infectious Diseases, PathWest Laboratory Medicine WA Queen Elisabeth II site and Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, WA, 6009, Australia

    R. J. Murray

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  1. J. O. Robinson
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  2. S. Pozzi - Langhi
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  3. M. Phillips
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  4. J. C. Pearson
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  5. K. J. Christiansen
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  6. G. W. Coombs
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  7. R. J. Murray
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Correspondence to J. O. Robinson.

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Robinson, J.O., Pozzi - Langhi, S., Phillips, M. et al. Formal infectious diseases consultation is associated with decreased mortality in Staphylococcus aureus bacteraemia. Eur J Clin Microbiol Infect Dis 31, 2421–2428 (2012). https://doi.org/10.1007/s10096-012-1585-y

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  • DOI: https://doi.org/10.1007/s10096-012-1585-y

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