Formal Infectious Diseases Specialist Consultation Improves Long-term Outcome of Methicillin-sensitive Staphylococcus Aureus Bacteremia
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This is an abstract. The full journal article is available to read via the link in the Source information below.
Background
Formal infectious diseases specialist (IDS) consultation has been shown to improve short-term outcome of Staphylococcus aureus bacteremia (SAB) but its effect on long-term outcome lacks evaluation.
Methods
Retrospective study of 367 methicillin-sensitive (MS) SAB patients followed for 10 years. The impact of formal IDS consultation on risk for new bacteremia and outcome during long-term follow-up were evaluated. Patients who died within 90 days were excluded to avoid interference from early deceased patients.
Results
304 (83%) patients had formal IDS consultation whereas 63 (17%) received informal or no IDS consultation. Formal consultation, compared to informal or lack of consultation, associated to a reduced risk for a new bacteremia caused by any pathogen within 1-year (OR 0.39, 95% CI 0.18-0.84, P=0.014, 8% vs. 17%), and within 3-years (OR 0.39, 95% CI 0.19-0.80, P=0.010, 9% vs. 21%) whereas a trend towards a lower risk was observed within 10-years (OR 0.56, 95% CI 0.29-1.08, P=0.079, 16% vs. 25%). Formal consultation, compared to informal or lack of consultation, improved outcome at 1-year (OR 0.16, 95% CI 0.06-0.44, P<0.001, 3% vs. 14%), at 3-years (OR 0.19, 95% CI 0.09-0.42, P<0.001, 5% vs. 22%) and at 10-years (OR 0.43, 95% CI 0.24-0.74, P=0.002, 27% vs. 46%). Considering all prognostic parameters formal consultation improved outcome (HR 0.42, 95% CI 0.27-0.65, P<0.001) and lowered risk for any new bacteremia (OR 0.45, 95% CI 0.23-0.88, P=0.02) during 10-years follow-up.
Conclusion
MS-SAB management by formal IDS consultation, compared to informal or lack of IDS consultation, reduces risk for any new bacteremia episodes and improves long-term prognosis up to ten years.
The full text of this article can be accessed via the Source information below.
Järvinen has received speakers honorary from Astellas, Biogen, Orion Pharma, and Pfizer and consultation fee from CLS Behring. Ruotsalainen has received speakers honorary from MSD.
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Primary Source
Open Forum Infectious Diseases