Impact of Infectious Disease Consultation on Clinical Management and Outcome of Patients with Bloodstream Infection: a Retrospective Cohort Study

Overview

Journal Sci Rep

Specialty Science

Date 2017 Oct 12

PMID 29018215

Citations 9

Authors

Guangmin Tang

Liang Huang

Zhiyong Zong

Affiliations

Soon will be listed here.

Abstract

The impact of consultation by infectious diseases (ID) physicians on management and outcomes of patients has not been determined in China. We assembled a retrospective cohort of 995 consecutive adult cases with bloodstream infections (BSI) in a major teaching hospital in China. Survival analysis was performed with Cox regression and the Kaplan-Meier curves. Among the 995 patients with BSI, 421 (42.3%) received consultation by ID physicians and 574 (57.7%) did not. ID consultation led to a significant lower hazard of death (hazard ratio [HR], 0.575; P < 0.05) and more appropriate antimicrobial use (95.0% vs 67.6%, P < 0.05). ID consultation was a protective factor among patients with BSI due to Gram-positive (HR, 0.551; P < 0.05) or Gram-negative (HR, 0.331; P < 0.05) bacteria. Multiple ID consultation was a protective factor (HR, 0.51; P < 0.05), while single consultation was not. In conclusion, ID consultation led to significant lower risk for patients with BSI and improved management. Multiple rather than single ID consultations reduced the hazard of death.

Citing Articles

Association Between Infectious Diseases Consultation and Mortality in Hospitalized Patients With Gram-negative Bloodstream Infection: A Retrospective Population-wide Cohort Study.

Ong S, Luo J, Fridman D, Lee S, Johnstone J, Schwartz K Clin Infect Dis. 2024; 79(4):855-863.

PMID: 38758977 PMC: 11478582. DOI: 10.1093/cid/ciae282.

Clinical Disease and Outcomes of Group B Streptococcus Bloodstream Infections at a Teaching Hospital in Saudi Arabia From 2015 to 2022.

Bajnaid N, Kaki R Cureus. 2024; 16(2):e54442.

PMID: 38510909 PMC: 10951937. DOI: 10.7759/cureus.54442.

Impact of a Pro-Active Infectious Disease Consultation on the Management of a Multidrug-Resistant Organisms Outbreak in a COVID-19 Hospital: A Three-Months Quasi-Experimental Study.

Bavaro D, De Gennaro N, Belati A, Diella L, Papagni R, Frallonardo L Antibiotics (Basel). 2023; 12(4).

PMID: 37107073 PMC: 10135160. DOI: 10.3390/antibiotics12040712.

Impact of a bloodstream infection stewardship program in hospitalized patients.

Dow G, MacLaggan T, Allard J J Assoc Med Microbiol Infect Dis Can. 2022; 7(3):196-207.

PMID: 36337596 PMC: 9629734. DOI: 10.3138/jammi-2022-0004.

The impact of infectious diseases consultation on the management and outcomes of Pseudomonas aeruginosa bacteraemia in adults: a retrospective cohort study.

Chiong F, Wasef M, Liew K, Cowan R, Tsai D, Lee Y BMC Infect Dis. 2021; 21(1):671.

PMID: 34243714 PMC: 8268285. DOI: 10.1186/s12879-021-06372-5.

References

Saunderson R, Gouliouris T, Nickerson E, Cartwright E, Kidney A, Aliyu S . Impact of routine bedside infectious disease consultation on clinical management and outcome of Staphylococcus aureus bacteraemia in adults. Clin Microbiol Infect. 2015; 21(8):779-85. PMC: 4509716. DOI: 10.1016/j.cmi.2015.05.026. View

Robinson J, Pozzi-Langhi S, Phillips M, Pearson J, Christiansen K, Coombs G . Formal infectious diseases consultation is associated with decreased mortality in Staphylococcus aureus bacteraemia. Eur J Clin Microbiol Infect Dis. 2012; 31(9):2421-8. DOI: 10.1007/s10096-012-1585-y. View

Byl B, Clevenbergh P, Jacobs F, Struelens M, Zech F, Kentos A . Impact of infectious diseases specialists and microbiological data on the appropriateness of antimicrobial therapy for bacteremia. Clin Infect Dis. 1999; 29(1):60-6; discussion 67-8. DOI: 10.1086/520182. View

Li J, Sexton D, Mick N, Nettles R, Fowler Jr V, Ryan T . Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis. 2000; 30(4):633-8. DOI: 10.1086/313753. View

Lahey T, Shah R, Gittzus J, Schwartzman J, Kirkland K . Infectious diseases consultation lowers mortality from Staphylococcus aureus bacteremia. Medicine (Baltimore). 2009; 88(5):263-267. PMC: 2881213. DOI: 10.1097/MD.0b013e3181b8fccb. View

Jenkins T, Price C, Sabel A, Mehler P, Burman W . Impact of routine infectious diseases service consultation on the evaluation, management, and outcomes of Staphylococcus aureus bacteremia. Clin Infect Dis. 2008; 46(7):1000-8. DOI: 10.1086/529190. View

Chang F, MacDonald B, Peacock Jr J, Musher D, Triplett P, Mylotte J . A prospective multicenter study of Staphylococcus aureus bacteremia: incidence of endocarditis, risk factors for mortality, and clinical impact of methicillin resistance. Medicine (Baltimore). 2003; 82(5):322-32. DOI: 10.1097/01.md.0000091185.93122.40. View

Vogel M, Schmitz R, Hagel S, Pletz M, Gagelmann N, Scherag A . Infectious disease consultation for Staphylococcus aureus bacteremia - A systematic review and meta-analysis. J Infect. 2015; 72(1):19-28. DOI: 10.1016/j.jinf.2015.09.037. View

Zhang C, Li S, Ji J, Shen P, Ying C, Li L . The professional status of infectious disease physicians in China: a nationwide cross-sectional survey. Clin Microbiol Infect. 2017; 24(1):82.e5-82.e10. DOI: 10.1016/j.cmi.2017.05.008. View

10.

Rieg S, Peyerl-Hoffmann G, de With K, Theilacker C, Wagner D, Hubner J . Mortality of S. aureus bacteremia and infectious diseases specialist consultation--a study of 521 patients in Germany. J Infect. 2009; 59(4):232-9. DOI: 10.1016/j.jinf.2009.07.015. View

11.

Forsblom E, Ruotsalainen E, Ollgren J, Jarvinen A . Telephone consultation cannot replace bedside infectious disease consultation in the management of Staphylococcus aureus Bacteremia. Clin Infect Dis. 2012; 56(4):527-35. DOI: 10.1093/cid/cis889. View

12.

Bai A, Showler A, Burry L, Steinberg M, Ricciuto D, Fernandes T . Impact of Infectious Disease Consultation on Quality of Care, Mortality, and Length of Stay in Staphylococcus aureus Bacteremia: Results From a Large Multicenter Cohort Study. Clin Infect Dis. 2015; 60(10):1451-61. DOI: 10.1093/cid/civ120. View

13.

Giannella M, Graziano E, Marconi L, Girometti N, Bartoletti M, Tedeschi S . Risk factors for recurrent carbapenem resistant Klebsiella pneumoniae bloodstream infection: a prospective cohort study. Eur J Clin Microbiol Infect Dis. 2017; 36(10):1965-1970. DOI: 10.1007/s10096-017-3020-x. View

14.

Pulcini C, Botelho-Nevers E, Dyar O, Harbarth S . The impact of infectious disease specialists on antibiotic prescribing in hospitals. Clin Microbiol Infect. 2014; 20(10):963-72. DOI: 10.1111/1469-0691.12751. View

15.

Fluckiger U, Zimmerli W, Sax H, Frei R, Widmer A . Clinical impact of an infectious disease service on the management of bloodstream infection. Eur J Clin Microbiol Infect Dis. 2000; 19(7):493-500. DOI: 10.1007/s100960000306. View

16.

Paulsen J, Solligard E, Damas J, DeWan A, Asvold B, Bracken M . The Impact of Infectious Disease Specialist Consultation for Staphylococcus aureus Bloodstream Infections: A Systematic Review. Open Forum Infect Dis. 2016; 3(2):ofw048. PMC: 4817315. DOI: 10.1093/ofid/ofw048. View

17.

Kaech C, Elzi L, Sendi P, Frei R, Laifer G, Bassetti S . Course and outcome of Staphylococcus aureus bacteraemia: a retrospective analysis of 308 episodes in a Swiss tertiary-care centre. Clin Microbiol Infect. 2006; 12(4):345-52. DOI: 10.1111/j.1469-0691.2005.01359.x. View

18.

Honda H, Krauss M, Jones J, Olsen M, Warren D . The value of infectious diseases consultation in Staphylococcus aureus bacteremia. Am J Med. 2010; 123(7):631-7. PMC: 3606273. DOI: 10.1016/j.amjmed.2010.01.015. View

19.

Lesprit P, Merabet L, Fernandez J, Legrand P, Brun-Buisson C . Improving antibiotic use in the hospital: Focusing on positive blood cultures is an effective option. Presse Med. 2011; 40(6):e297-303. DOI: 10.1016/j.lpm.2010.12.014. View

20.

Nagao M, Iinuma Y, Saito T, Matsumura Y, Shirano M, Matsushima A . Close cooperation between infectious disease physicians and attending physicians can result in better management and outcome for patients with Staphylococcus aureus bacteraemia. Clin Microbiol Infect. 2010; 16(12):1783-8. DOI: 10.1111/j.1469-0691.2010.03156.x. View