Outcome of Staphylococcus aureus Bacteremia According to Compliance with Recommendations of Infectious Diseases Specialists: Experience with 244 Patients

Abstract

To determine whether recommendations of infectious diseases specialists affect outcome for patients, we evaluated 244 hospitalized patients with Staphylococcus aureus bacteremia. We offered our management recommendations to each patient's physicians and then assessed the clinical outcome for both patients for whom our consultative advice was followed and those for whom our advice was not heeded. All patients were followed up for 12 weeks after their first positive blood culture. Our management advice was followed for 112 patients (45.9%) and partially or completely ignored for 132 patients (54.1%). Patients for whom our recommendations were followed were more likely to be cured of their S. aureus infection and less likely to relapse (P < .01), despite having significantly more metastatic infections (P < .01) at the outset of therapy, than were those for whom our recommendations were not followed. Failure to follow recommendations to remove an infected intravascular device was the most important risk for treatment failure. After controlling for other factors, logistic regression analysis revealed that patients whose intravascular device was not removed were 6.5 times more likely to relapse or die of their infection than were those whose device was removed. Our findings suggest that patient-specific management advice by infectious diseases consultants can improve the clinical outcome for patients with S. aureus bacteremia.

Impact of gastroenterology consultation on the outcomes of patients admitted to the hospital with decompensated cirrhosis

“…12 Health maintenance organizations that restrict access to specialists are associated with a decrease in patients' trust and confidence in their primary care physician, lower patient satisfaction, increased desire to leave the managed care plan, and a lower likelihood of recommending the group to a friend. 13,14 Several studies have shown that specialists do a better job than generalists in the management of patients with suspected myocardial chest pain, 15 unstable angina, 16 acute myocardial infarction, 17,18 asthma, 19,20 diabetes, 21 Staphylococcus aureus bacteremia, 22 and osteoarthritis. 23 In contrast, other studies have shown that specialists were no better than generalists were in the management of patients with severe chronic obstructive pulmonary disease 24 or hypertension and non-insulin-dependent diabetes mellitus.…”

Clinical and laboratory considerations for the rapid detection of carbapenem-resistant Enterobacteriaceae

“…Earlier identification of patients with CRE infection should also lead to earlier consultation with Infectious Diseases (ID) specialists. ID consultation has been associated with favorable outcomes for patients with S. aureus bloodstream infections 50,51 and should similarly benefit patients with invasive CRE infections.…”

Recent trends in spinal infections: retrospective analysis of patients treated during the past 50 years

“…Spinal infection is a relatively rare condition and accounts for [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16].7% of all cases of osteomyelitis [6,11,14,19]. In developed countries, improved public hygiene reduced the incidence of spinal infections in the 1970s; however, several papers [2,3,7,19] have warned that spinal infections have been more frequent recently with the increase of immunocompromised hosts, human immunodeficiency virus (HIV) infection and immigrants from developing countries.…”