title: Mortality of S. aureus bacteremia and infectious diseases specialist consultation--a study of 521 patients in Germany.
abstract: OBJECTIVE
  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.
authors: Department of Medicine, Center for Infectious Diseases and Travel Medicine, University Medical Center Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany. siegbert.rieg@uniklinik-freiburg.de
authors: Siegbert
authors: S
authors: Rieg
authors: Gabriele
authors: G
authors: Peyerl-Hoffmann
authors: Katja
authors: K
authors: de With
authors: Christian
authors: C
authors: Theilacker
authors: Dirk
authors: D
authors: Wagner
authors: Johannes
authors: J
authors: Hübner
authors: Markus
authors: M
authors: Dettenkofer
authors: Achim
authors: A
authors: Kaasch
authors: Harald
authors: H
authors: Seifert
authors: Christian
authors: C
authors: Schneider
authors: Winfried V
authors: WV
authors: Kern
mesh_terms: D000368:Aged; D016470:Bacteremia / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D015331:Cohort Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D013211:Staphylococcus aureus; D016896:Treatment Outcome