Association of Infectious Diseases Consultation With Long-term Postdischarge Outcomes Among Patients With <i>Staphylococcus aureus</i> Bacteremia

Goto, Michihiko; Jones, Michael P.; Schweizer, Marin L.; Livorsi, Daniel J; Perencevich, Eli N.; Richardson, Kelly; Beck, Brice; Alexander, Bruce; Ohl, Michael

doi:10.1001/jamanetworkopen.2019.21048

Cited by 18 publications

(9 citation statements)

References 49 publications

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“…Notably, however, more than twice the NIDCs than IDCs respondents reported that they would routinely prescribe OAT for S. aureus BSI, suggesting that given the nuance around treatment of S. aureus BSI, there may still be additional room for collaboration between IDCs and NIDCs on treating this important infection according to the most current available evidence and established standards of care, as involvement of IDC in management of S. aureus BSI has improved patient outcomes. [29][30][31][32][33] Furthermore, this finding highlights the impact of this gap in evidence for treatment of uncomplicated S. aureus BSIs and the need for additional, carefully designed studies to better define the role of oral antibiotics in this syndrome.…”

Section: Discussionmentioning

confidence: 92%

“…Despite recommendations against obtaining routine blood cultures in individuals with cellulitis, 26,27 the data demonstrating that these are frequently obtained, 28 combined with a lower-than-expected use of OAT in this syndrome by IDCs, suggests that additional opportunities exist for education of IDCs on the possible merits of adopting this practice. Appropriate treatment of Staphylococcus aureus BSI is highly effective for clinical outcomes, and ID consultation has been demonstrated to improve clinical care through adherence to guidelines and reduced mortality [29][30][31][32][33] Fewer IDC reported routinely using OAT for MRSA BSI secondary to drained gluteal abscess than NIDCs, and IDCs were more likely to report longer treatment and routinely repeating blood cultures. When they chose OAT, more IDCs reported use of high bioavailability treatments like linezolid.…”

Section: Discussionmentioning

confidence: 99%

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Impact of specialty on the self-reported practice of using oral antibiotic therapy for definitive treatment of bloodstream infections

Marcelin

Keintz²,

Ma³

et al. 2023

ASHE

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Background: No established guidelines exist regarding the role of oral antibiotic therapy (OAT) to treat bloodstream infections (BSIs), and practices may vary depending on clinician specialty and experience. Objective: To assess practice patterns regarding oral antibiotic use for treatment of bacteremia in infectious diseases clinicians (IDCs, including physicians and pharmacists and trainees in these groups) and non–infectious diseases clinicians (NIDCs). Design: Open-access survey. Participants: Clinicians caring for hospitalized patients receiving antibiotics. Methods: An open-access, web-based survey was distributed to clinicians at a Midwestern academic medical center using e-mail and to clinicians outside the medical center using social media. Respondents answered questions regarding confidence prescribing OAT for BSI in different scenarios. We used χ2 analysis for categorical data evaluated association between responses and demographic groups. Results: Of 282 survey responses, 82.6% of respondents were physicians, 17.4% pharmacists, and IDCs represented 69.2% of all respondents. IDCs were more likely to select routine use of OAT for BSI due to gram-negative anaerobes (84.6% vs 59.8%; P < .0001), Klebsiella spp (84.5% vs 69.0%; P < .009), Proteus spp (83.6% vs 71.3%; P < .027), and other Enterobacterales (79.5% vs 60.9%; P < .004). Our survey results revealed significant differences in selected treatment of Staphylococcus aureus syndromes. Fewer IDCs than NIDCs selected OAT to complete treatment for methicillin-resistant S. aureus (MRSA) BSI due to gluteal abscess (11.9% vs 25.6%; P = .012) and methicillin-susceptible S. aureus (MSSA) BSI due to septic arthritis (13.9% vs 20.9%; P = .219). Conclusions: Practice variation and discordance with evidence for the use of OAT for BSIs exists among IDCs versus NIDCs, highlighting opportunities for education in both clinician groups.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Impact of specialty on the self-reported practice of using oral antibiotic therapy for definitive treatment of bloodstream infections

Marcelin

Keintz²,

Ma³

et al. 2023

ASHE

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“…We selected SAB recurrence as the primary clinical outcome because it is a complication of SAB that may be preventable with optimized management. 26 SAB recurrence was defined as a positive blood culture taken over 28 days and within 6 months following the index episode. The isolates had to have a similar antibiotic susceptibility pattern.…”

Section: Methodsmentioning

confidence: 99%

Increasing Pediatric Infectious Diseases Consultation Rates for Staphylococcus aureus Bacteremia

Gordon

Akindele

Schumacher³

et al. 2022

Pediatric Quality &Amp; Safety

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Introduction: Staphylococcus aureus bacteremia (SAB) in children is associated with significant mortality and morbidity, including recurrent bacteremia. Infectious disease consultation (IDC) improves SAB outcomes in adult patients. However, increasing IDC and impact for pediatric patients with SAB is not well described. Methods: This quality improvement project aimed to increase IDC for SAB events at a quaternary pediatric medical center. First, we evaluated the local practices regarding pediatric SAB and engaged stakeholders (July 2018–August 2020). We added an advisory comment supporting IDC for SAB to all blood culture results in September 2020. Using statistical process control charts, we monitored the number of SAB events with IDC before a SAB event without IDC. Finally, we evaluated SAB recurrences before and after initiating the advisory comment. Results: In the baseline period, 30 of 49 (61%) SAB events received an IDC with a mean of 1.4 SAB events with IDC before a SAB event without IDC. Postintervention, 22 of 23 (96%) SAB events received IDC with a mean of 14 events with IDC before 1 event without IDC. The SAB recurrence rate was 8%, with 6 events in 4 children; none of the index cases resulting in recurrence received an IDC ( P = 0.0002), and all occurred before any intervention. Conclusions: An electronic advisory comment supporting IDC for SAB significantly increased the rate of pediatric IDC with no further SAB recurrence episodes following intervention. This low-resource intervention may be considered in other pediatric centers to optimize SAB management.

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“…This program focuses on training master and doctoral level nurse educators qualified to teach in Thai nursing programs as well as in various programs across 10 other countries in East and Southeast Asia. Nursing capacity in Africa and the Middle East has been strengthened by incorporating advanced teaching methodologies and curriculum development in such a way to ensure Rwandan ownership and "cultural humility" (34,35).…”

Section: Global Perspectivesmentioning

confidence: 99%

Incorporation of Nurse Practitioners and Physician Assistants into patient care teams - Focus on infectious Diseases

Bingen¹,

Krueger²,

Lakatos³

et al. 2022

Al-Kindy Col. Med. J

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There is a global shortage of health care providers needed to address all levels of primary and specialty care. The recent COVID-19 pandemic also highlights the importance and added value of health professionals with specialty training in infectious diseases. In the United States, advanced practice providers (APPs) are being engaged to meet the expanding demand for generalist and specialist patient care. The history and development of advanced practice registered nurses (APRNs) and physician assistants (PAs), are discussed as collaborative healthcare providers to promote better understanding of the ways they can be incorporated into a healthcare system. An example of how APPs are utilized to provide both inpatient and outpatient care of persons with infectious diseases is illustrated at our midwestern United States regional medical center. Especially relevant for regions of the world where both nurses and physicians are in short supply, this paper identifies ways that healthcare leaders can support, develop and strategically utilize APPs to provide critically necessary functions and achieve excellent outcomes. Challenges to future healthcare administration are articulated and compared with World Health Organization roadmap objectives for nursing that can be expanded to better utilize all APPS as valuable healthcare professionals.

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Association of Infectious Diseases Consultation With Long-term Postdischarge Outcomes Among Patients With Staphylococcus aureus Bacteremia

Cited by 18 publications

References 49 publications

Impact of specialty on the self-reported practice of using oral antibiotic therapy for definitive treatment of bloodstream infections

Impact of specialty on the self-reported practice of using oral antibiotic therapy for definitive treatment of bloodstream infections

Increasing Pediatric Infectious Diseases Consultation Rates for Staphylococcus aureus Bacteremia

Incorporation of Nurse Practitioners and Physician Assistants into patient care teams - Focus on infectious Diseases

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