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  • Title: Mortality of S. aureus bacteremia and infectious diseases specialist consultation--a study of 521 patients in Germany.
    Author: Rieg S, Peyerl-Hoffmann G, de With K, Theilacker C, Wagner D, Hübner J, Dettenkofer M, Kaasch A, Seifert H, Schneider C, Kern WV.
    Journal: J Infect; 2009 Oct; 59(4):232-9. PubMed ID: 19654021.
    Abstract:
    OBJECTIVES: To evaluate the relationship between mortality of bloodstream infection due to Staphylococcus aureus and infectious diseases specialist consultation and other factors potentially associated with outcomes. METHODS: A 6-year cohort study was conducted at a 1600-bed university hospital. Consecutive adult patients with S. aureus bacteremia were assessed using a standardised data collection and review form. A new infectious diseases service increased its consultations for S. aureus bacteremia from 33% of cases in 2002 to >80% in 2007. Infectious disease consultation and other factors potentially associated with in-hospital mortality were analysed by multivariate logistic regression. RESULTS: A total of 521 patients were studied. All-cause in-hospital mortality was 22%, 90-day mortality was 32%. Factors significantly associated with in-hospital mortality in multivariate analysis were ICU admission (OR 5.8, CI 3.5-9.7), MRSA (OR 2.6, CI 1.4-4.9), age >/=60 years (OR 2.4, CI 1.4-4.2), a diagnosis of endocarditis (OR 2.8, CI 1.4-5.7), a non-fatal underlying disease/comorbidity according to the McCabe classification (OR 0.2, CI 0.1-0.4), and infectious disease specialist consultation (OR 0.6, CI 0.4-1.0). CONCLUSIONS: These data suggest that outcome of S. aureus bacteremia may be improved by an expert consultation service.
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