Journal
CLINICAL INFECTIOUS DISEASES
Volume 56, Issue 4, Pages 527-535Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/cid/cis889
Keywords
Staphylococcus aureus bacteraemia; infectious disease specialist consultation; deep infection foci
Categories
Funding
- Medical Society of Finland
Ask authors/readers for more resources
Background. Infectious disease specialist (IDS) consultation improves the outcome of Staphylococcus aureus bacteremia (SAB). Although telephone consultations constitute a substantial part of IDS consultations, their impact on treatment outcome lacks evaluation. Methods. We retrospectively followed 342 SAB episodes with 90-day follow-up, excluding 5 methicillin-resistant S. aureus SAB cases. Patients were grouped according to bedside, telephone, or no IDS consultation within the first week. Patients with fatal outcome within 3 days after onset of SAB were excluded to allow for the possibility of death occurring before IDS consultation. Results. Seventy-two percent of patients received bedside, 18% telephone, and 10% no IDS consultation. Patients with bedside consultation were less often treated in an intensive care unit during the first 3 days compared to those with telephone consultation (odds ratio [OR], 0.53; 95% confidence interval [CI],.29-.97; P = .037; 21% vs 34%), with no other initial differences between these groups. Patients with bedside consultation more often had deep infection foci localized as compared to patients with telephone consultation (OR, 3.11; 95% CI, 1.74-5.57; P < .0001; 78% vs 53%). Patients with bedside consultation had lower mortality than patients with telephone consultation at 7 days (OR, 0.09; 95% CI,.02-.49; P = .001; 1% vs 8%), at 28 days (OR, 0.27; 95% CI,.11-.65; P = .002; 5% vs 16%) and at 90 days (OR, 0.25; 95% CI,.13-.51; P < .0001; 9% vs 29%). Considering all prognostic markers, 90-day mortality for telephone-consultation patients was higher (OR, 2.31; CI, 95% 1.22-4.38; P = .01) as compared to bedside consultation. Conclusions. Telephone IDS consultation is inferior to bedside IDS consultation.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available