ID consult associated with 59% reduction in mortality among patients with candidemia
Click Here to Manage Email Alerts
Infectious disease consultation was associated with a 59% reduction in mortality among patients hospitalized with candidemia, according to the results of a systematic review and meta-analysis published in Open Forum Infectious Diseases.
“Infectious disease consult in patients with Staphylococcus aureus bacteremia (SAB) is known to be associated with a decrease in 30-day mortality, 90-day mortality, length of stay, SAB relapse rates, and more frequent adherence to standards of care,” Takaaki Kobayashi, MD, an infectious disease specialist at the University of Iowa, told Healio.
Kobayashi said that although infectious disease consults occur for all or most patients with SAB, this is not the case for patients with candidemia.
“Recent studies suggest that patients with candidemia receiving an IDC have lower mortality compared to those without IDC. However, these reports were single-center studies, and many have had small sample sizes, limiting the generalizability of the findings,” he said. “Therefore, we aimed to add to the existing evidence base with a new retrospective cohort study at our institution, the University of Iowa, and then by performing a systematic literature review and meta-analysis to evaluate the impact of IDC on mortality in patients with candidemia.”
For the study, Kobayashi and colleagues compared the crude mortality rate between patients with candidemia who received and infectious disease consult and those who did not. They then searched five databases through February 2020 and performed a meta-analysis of the impact of infectious disease consult on mortality of patients with candidemia.
Overall, they identified 151 patients with candidemia at the University of Iowa Hospitals and Clinics between 2015 and 2019 of whom 129 (85%) received an infectious disease consult. According to Kobayashi and colleagues, 30-day and 90-day mortality rates were significantly lower in the infectious disease consultation group, 18% vs. 50% (P = .002) and 23% vs. 50% (P = .0022), respectively.
Additionally, the systematic review returned 13 studies. According to the researchers, 49% of the 3,687 patients from the 13 studies had an infectious disease consultation. Kobayashi and colleagues found that the overall mortality was 38.2%, with a significant difference in favor of the infectious disease consultation group (28.4% vs. 47.6%) with a pooled RR of 0.41 (95% Cl, 0.35-0.49).
“This study is the first systematic literature review and meta-analysis to evaluate the association between infectious disease consultation and candidemia mortality,” Kobayashi said. “Infectious disease consultation was associated with significantly lower mortality and more frequent adherence to standards of care. It should be considered in all patients with candidemia.”
Collapse
Read more about
Click Here to Manage Email Alerts