Mandatory infectious diseases consultation for MRSA bacteremia is associated with reduced mortality.

TitreMandatory infectious diseases consultation for MRSA bacteremia is associated with reduced mortality.
Publication TypeJournal Article
Year of Publication2014
AuthorsTissot, F, Calandra, T, Prod'hom, G, Taffé, P, Zanetti, G, Greub, G, Senn, L
JournalJ Infect
Volume69
Issue3
Pagination226-34
Date Published2014 Sep
DOI10.1016/j.jinf.2014.05.004
ISSN1532-2742
ISBN Number1532-2742 (Electronic)
Mots-clésAged, Aged, 80 and over, Anti-Bacterial Agents, Bacteremia, Blood, Cross Infection, Echocardiography, Female, Hospital Mortality, Humans, Infectious Disease Medicine, Male, Methicillin-Resistant Staphylococcus aureus, Middle Aged, Organizational Policy, Practice Guidelines as Topic, Referral and Consultation, Retrospective Studies, Soft Tissue Infections, Staphylococcal Skin Infections, Vancomycin
Abstract

OBJECTIVES: Although infectious disease (ID) consultation has been associated with lower mortality in Staphylococcus aureus bloodstream infections, it is still not mandatory in many centers. This study aimed at assessing the impact of ID consultation on diagnostic and therapeutic management of methicillin-resistant S. aureus (MRSA) bacteremia.

METHODS: Retrospective cohort study of all patients with MRSA bacteremia from 2001 to 2010. ID consultations were obtained on request between 2001 and 2006 and became mandatory since 2007.

RESULTS: 156 episodes of MRSA bacteremia were included, mostly from central venous catheter (32%) and skin and soft tissue (19%) infections. ID consultation coverage was 58% between 2001 and 2006 and 91% between 2007 and 2010. ID consultation was associated with more echocardiography (59% vs. 26%, p < 0.01), vancomycin trough level measurements (99% vs. 77%, p < 0.01), follow-up blood cultures (71% vs. 50%, p = 0.05), deep-seated infections (43% vs. 16%, p < 0.01), more frequent infection source control (83% vs. 57%, p = 0.03), a longer duration of MRSA-active therapy (median and IQR: 17 days, 13-30, vs. 12, 3-14, p < 0.01) and a 20% reduction in 7-day, 30-day and in-hospital mortality.

CONCLUSIONS: ID consultation was associated with a better management of patients with MRSA bacteremia and a reduced mortality.

Notes

Publication types: Journal Article Publication Status: ppublish

Alternate URL

http://www.ncbi.nlm.nih.gov/pubmed/24844825?dopt=Abstract

WOS ID (UT)

000341988500003

Alternate JournalJ. Infect.
Citation Key / SERVAL ID3569
Peer reviewNon-Refereed
PubMed ID24844825

                         

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