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.)
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Received: 4 Apr 2022 / Revised: 14 May 2022 / Accepted: 17 May 2022 / Published: 15 Jun 2022
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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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.