Background: There is some observational evidence for the benefit of having an infectious diseases (ID) physician provide consultative support in the care of patients with Staphylococcus aureus bacteremia (SAB). A recent randomized trial was unable to document a similar benefit, although the control group received a concurrent stewardship intervention. We wanted to determine the effect of an ID consult on SAB patient outcomes across the 30 hospitals of a healthcare network in the South- Western U.S. within an ethnically diverse hospitalized population.
Methods: We utilized microbiology lab data from the hospital network’s EMR, to identify SAB Inpatient cases. SAB cases were stratified by ID vs no ID consult. Primary patient outcomes to compare were transfer to intensive care, in-hospital mortality, and length of hospital stay. The analysis was done using STATA.
Results: We identified 3,788 SAB patients between 1/1/2022 and 05/31/2024. The mean age (SD) was 61.4 (17.5) years and 63.9% were males. 2,714 patients had an ID consult (71.6%). When comparing the effect of ID consultation on patient outcomes, we found fewer transfers to the ICU (34.8% vs 41%, p< 0.001) and significantly lower inpatient mortality (12.1% vs 21.9%, p< 0.001). However, the mean length of stay was higher in the ID consult group (12.5 days vs 11.5 days).
Conclusions: In this large observational study of a non-profit hospital network in the Western U.S., patients who were seen by an ID physician for SAB were less often transferred to the ICU and had lower inpatient mortality. This study documents the benefit of ID physician involvement in the management of SAB .