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

    Access Status
    Fulltext not available
    Authors
    Robinson, J.
    Pozzi-Langhi, S.
    Phillips, M.
    Pearson, J.
    Christiansen, K.
    Coombs, Geoffrey
    Murray, R.
    Date
    2012
    Type
    Journal Article
    
    Metadata
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    Citation
    Robinson, J.O. and Pozzi-Langhi, S and Phillips, M. and Pearson, J.C. and Christiansen, K.J. and Coombs, G.W. and Murray, R.J. 2012. Formal infectious diseases consultation is associated with decreased mortality in Staphylococcus aureus bacteraemia. European Journal of Clinical Microbiology and Infectious Diseases. 31 (9): pp. 2421-2428.
    Source Title
    European Journal of Clinical Microbiology and Infectious Diseases
    DOI
    10.1007/s10096-012-1585-y
    ISSN
    0934-9723
    URI
    http://hdl.handle.net/20.500.11937/31672
    Collection
    • Curtin Research Publications
    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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