Early Infectious Disease Consultations in Staphylococcus Aureus Bacteremia

Early Infectious Disease Consultation for Better Outcomes From Staphylococcus Aureus Bacteremia

The primary objective is to determine if early infectious disease (ID) consultation (defined as within 48 hours of a positive blood culture) will reduce mortality rates from Staphylococcus aureus bacteremia (SAB). This study will also determine if such consultations could reduce the duration of hospitalisation, recurrence and financial costs in patients with this infection.

Bacteremia is a serious manifestation of Staphylococcus aureus infection with an attributable mortality as high as 25% in MRSA bacteremia. More than a third of patients end up with complications such as endocarditis, osteomyelitis or pneumonia.

Overall the outcome of patients with respect to mortality or recurrence is better in patients who have an eradicable focus and have received an appropriate antibiotic dose and duration. Also complicated bacteremia is more common in patients with

• persistent bacteremia or fever
• prosthetic device
• new murmur
• skin findings of a systemic infection

Based on this evidence, an ID consultation could improve the outcomes of patients with SAB by

• Advising adequate antibiotic dosage and duration
• Sourcing out and counselling eradication of any focus of infection

Inclusion Criteria:

• All inpatients at the National University Hospital with Staphylococcus aureus (both methicillin sensitive and methicillin resistant) bacteremia isolated within the defined time period

Exclusion Criteria:

• Patients who died or were discharged before the notification from the laboratory
• Neonates
• Polymicrobial bacteremia