Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Luketina, RR.
Impact of Routine Infectious Diseases Service Consultation on Applied Levels of Staphylococcus aureus Bacteremia Standards of Care and Outcomes of patients with Staphylococcus aureus Bacteremia
[ Diplomarbeit ] Medical University of Graz; 2012. pp. 78
[OPEN ACCESS]
FullText
- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Krause Robert
- Valentin Thomas
- Altmetrics:
- Abstract:
- Abstract: Background: Staphylococcus aureus bacteremia (SAB) is associated with high morbidity and mortality. Strategies to improve management and outcome of this disease are needed. This thesis determines the impact of routine infectious disease consultation (IDC) on adherence to standards of care and mortality due to SAB. Patients and Methods: We analysed clinical records of all patients from a SAB database using a standardized questionnaire. The data collection was based on the hospital electronic data system MEDocs. All episodes of SAB from the department of internal medicine over two and a half years were used. Data from patients before establishment of routine infectious disease consultation were analysed retrospectively, data from patients with intervention were analysed prospectively. Results: A total of 138 cases of Staphylococcus aureus bacteremia were evaluated. Nine patients were excluded because they died within three days after the blood culture was drawn. Infectious disease consultation was performed in 90 out of the remaining 129 cases. Removal of intravascular foreign bodies (95% vs. 67%, p<0.009), obtaining a follow-up blood culture (88% vs. 26%, p<0.001), use of a parenteral antistaphylococcal beta-lactam therapy for MSSA (97% vs. 68%, p<0.0001), adequate duration of treatment of at least 14 days for uncomplicated bacteremia and at least 28 days for complicated bacteremia (88% vs. 30%, p<0.001) and the performance of echocardiography (87% vs. 18%, p<0.0001) were adhered to more frequently with infectious disease consultation. Mortality decreased in patients who received infectious disease consultation (p=0.028). Conclusion: This study showed that infectious disease consultation improves the management of SAB and the adherence to standards of care. Mortality from SAB decreases with infectious disease consultation. Routine infectious disease consultation should be established for all patients with S. aureus bacteremia.