Mortality of S. aureus bacteremia and infectious diseases specialist consultation--a study of 521 patients in Germany.
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.
Rieg
Siegbert
S
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
Peyerl-Hoffmann
Gabriele
G
de With
Katja
K
Theilacker
Christian
C
Wagner
Dirk
D
Hübner
Johannes
J
Dettenkofer
Markus
M
Kaasch
Achim
A
Seifert
Harald
H
Schneider
Christian
C
Kern
Winfried V
WV
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