Private Practice Infectious Disease

(ISSN: 2770-4629) Open Access Journal
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PPID 2022, 2(1), 4; doi: 10.55636/ppid2010004

Impact of Infectious Disease Consultation on S. aureus Bacteremia Mortality

1 Department of Population Health, University of Kansas School of Medicine–Wichita, Wichita, KS 67214, USA; (E.A.); (H.O.)
2 Ascension via Christi Hospitals, Wichita, KS 67214, USA; (L.B.); (M.A.)
* Corresponding author: or
* Author to whom correspondence should be addressed.
Received: 4 Apr 2022 / Revised: 14 May 2022 / Accepted: 17 May 2022 / Published: 15 Jun 2022
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Abstract

Objective: This study evaluated the impact of a hospital policy requiring infectious disease (ID) consultation and follow-up from an antimicrobial stewardship (AMS) pharmacist-driven team on S. aureus Bacteremia (SAB) patient mortality and improved clinical outcomes. Methods: This retrospective study included adult inpatients with SAB from 1 August 2016 to 30 May 2018 (pre-policy) and June 1 2018 to 29 February 2020 (post-policy). The primary outcome variable was in-hospital mortality, and secondary outcomes were 30-day readmission rate, acute kidney injury (AKI) at discharge, stay length, and adherence to evidence-based treatment. Results: The final sample included 435 patients for analysis. Management by non-ID physicians was associated with an 8.1 increased likelihood of mortality while hospitalized (CI 95%, 3.701–17.569). Overall mortality was reduced from 11% (n = 25) pre-policy to 6% (n = 13) after policy implementation (p = 0.07). Patients with antibiotics managed by non-ID physicians were 3 times more likely to be readmitted within 30 days. Those with a history of being immunocompromised (64% vs. 36%), or cardiovascular disease (56% vs. 44%), and patients whose providers followed guidelines (23% vs. 7%) were more likely to be discharged with AKI. Policy implementation reduced non-consultant cases from 11% to 0%. Conclusion: A policy of mandatory ID consultation with pharmacist-driven AMS review to ensure compliance can improve patient mortality, 30-day readmission rates, and clinical outcomes.
Keywords: infectious diseases consultation; MRSA; bloodstream infection
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
CITE
Killblane, T.; Ablah, E.; Okut, H.; Bricker, L.; Assi, M. Impact of Infectious Disease Consultation on S. aureus Bacteremia Mortality. private_pract_infectious_disease 2022, 2, 4.
Killblane T, Ablah E, Okut H, Bricker L, Assi M. Impact of Infectious Disease Consultation on S. aureus Bacteremia Mortality. Private Practice Infectious Disease. 2022; 2(1):4.
Killblane, Tiffany; Ablah, Elizabeth; Okut, Hayrettin; Bricker, Lauren; Assi, Maha. 2022. "Impact of Infectious Disease Consultation on S. aureus Bacteremia Mortality." private_pract_infectious_disease 2, no. 1: 4.
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