gms | German Medical Science

131. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

25.03. - 28.03.2014, Berlin

Staphylococcus aureus Bacteremia – a challenge in surgery – Impact of Infectious disease consultation on patient’s outcome and survival

Meeting Abstract

  • Ruzica-Rosalia Luketina - Krankenhaus der Barmherzigen Schwestern Linz, Allgemein-und Viszeralchirurgie, Linz
  • Thomas Valentin - Medizinische Universität Graz, Universitätsklinik für Innere Medizin, Abteilung für Infektiologie, Graz
  • Martin Hönigl - Medizinische Universität Graz, Universitätsklinik für Innere Medizin, Abteilung für Infektiologie, Graz
  • Ines Zollner-Schwetz - Medizinische Universität Graz, Universitätsklinik für Innere Medizin, Abteilung für Infektiologie, Graz
  • Klaus Emmanuel - Krankenhaus der Barmherzigen Schwestern Linz, Allgemein-und Viszeralchirurgie, Linz
  • Robert Krause - Medizinische Universität Graz, Universitätsklinik für Innere Medizin, Abteilung für Infektiologie, Graz

Deutsche Gesellschaft für Chirurgie. 131. Kongress der Deutschen Gesellschaft für Chirurgie. Berlin, 25.-28.03.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. Doc14dgch393

doi: 10.3205/14dgch393, urn:nbn:de:0183-14dgch3934

Published: March 21, 2014

© 2014 Luketina et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Introduction: Staphylococcus aureus Bacteremia (SAB) is associated with a high mortality. Strategies for optimal management include the removal of intravascular foreign bodies, adequate treatment (i.e. antistaphylococcal betalactam for methicillin-susceptible Staphylococcus aureus, follow-up blood cultures, performance of an echocardiogram and adequate treatment duration). It is well known that these standards of care are essential for the outcome of patients with SAB. It has also been suggested, that combination treatment for indwelling foreign bodies and for complicated SAB might be of benefit. The aim of our study was to determine the impact of infectious disease (ID) consultation on these five standards of care and mortality.

Material and methods: We analysed data from our prospective SAB database. All episodes of SAB from the department of surgery and internal medicine over 30 months before and after implementation of routine ID consultation for SAB were used. The standards of care met with and without infectious disease consultation were compared. Routine ID consultation was implemented after 10 months.

Results: We analysed 138 patients in the study period. Nine patients were excluded, because they died within three days after the blood culture was drawn. Infectious disease consultation was performed in 90 (79,7%) of the remaining 129 patients. There was no significant difference between the groups concerning sex, age, severity of illness score, Charlson comorbity index, or MRSA rate. The number of standards of care met was significantly higher and mortality lower (p=0.028) in patients receiving routine ID consultation. All standards of care met could significantly be increased, two additional standards were also significantly more often achieved.

Conclusion: Routine Infectious diseases consultation improved the adherence to management guidelines of SAB. Mortality decreased with routine infectious disease consultation.