ID consultation lowers 30-day mortality in patients with Enterococcus bacteremia
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Patients hospitalized with Enterococcus bacteremia experienced significantly lower 30-day mortality after receiving an infectious disease consultation compared with those who did not, according to findings published in Open Forum Infectious Diseases.
“Numerous studies in Staphylococcus aureus bacteremia have demonstrated improved mortality in patients who receive infectious diseases (ID) consultation,” Rachael A. Lee, MD, of the Department of Medicine, Division of Infectious Diseases, at the University of Alabama at Birmingham, told Healio. “At our institution, we have previously shown better adherence to guidelines and improved survival in patients with candidemia. We wanted to assess if there were similar findings for patients with Enterococcus bacteremia who receive ID consultation, particularly given there are no specified guidelines for the care of patients with Enterococcus.”
In a single-center, retrospective cohort study, Lee and colleagues examined 205 patients being treated for Enterococcus bacteremia from Jan. 1, 2015 to June 30, 2016 and the effects of an ID consult on those patients, looking specifically at whether ID consultation improves mortality in these patients.
All patients included in the study were aged 18 years or older. The primary outcome was in-hospital mortality within 30 days.
The median age of participants was 59 years. Slightly more than half of patients (52%) were men.
According to the study results, 64% of the patients involved received ID consultation. These patients were more likely to undergo repeat cultures to confirm clearance of enterococcal bloodstream infections (99% vs. 74%; P < .001), echocardiography (79% vs. 45%; P < .001), surgical intervention (20% vs. 7%; P = .01) and have appropriate duration of antibiotic therapy (90% vs 46%; P < .001). Overall, the researchers determined that 30-day mortality was significantly greater in the group that did not receive ID consultation (27% vs 12%; P < .007).
“This paper adds to the growing evidence that ID consultation can reduce 30-day mortality in certain infections,” Lee concluded. “Further multicenter trials are needed, but based on our institutional data, we have implemented automatic ID consultation through our electronic medical record for S. aureus, Candida and Enterococcus.” – by Caitlyn Stulpin
Disclosures: Lee reports receiving personal fees from Prime Education, Inc., outside the submitted work. Please see the study for all other authors’ relevant financial disclosures.
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