Mortality of S. aureus bacteremia and infectious diseases specialist consultation--a study of 521 patients in Germany

J Infect. 2009 Oct;59(4):232-9. doi: 10.1016/j.jinf.2009.07.015. Epub 2009 Aug 3.


Objectives: To evaluate the relationship between mortality of bloodstream infection due to Staphylococcus aureus and infectious diseases specialist consultation and other factors potentially associated with outcomes.

Methods: A 6-year cohort study was conducted at a 1600-bed university hospital. Consecutive adult patients with S. aureus bacteremia were assessed using a standardised data collection and review form. A new infectious diseases service increased its consultations for S. aureus bacteremia from 33% of cases in 2002 to >80% in 2007. Infectious disease consultation and other factors potentially associated with in-hospital mortality were analysed by multivariate logistic regression.

Results: A total of 521 patients were studied. All-cause in-hospital mortality was 22%, 90-day mortality was 32%. Factors significantly associated with in-hospital mortality in multivariate analysis were ICU admission (OR 5.8, CI 3.5-9.7), MRSA (OR 2.6, CI 1.4-4.9), age >/=60 years (OR 2.4, CI 1.4-4.2), a diagnosis of endocarditis (OR 2.8, CI 1.4-5.7), a non-fatal underlying disease/comorbidity according to the McCabe classification (OR 0.2, CI 0.1-0.4), and infectious disease specialist consultation (OR 0.6, CI 0.4-1.0).

Conclusions: These data suggest that outcome of S. aureus bacteremia may be improved by an expert consultation service.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Bacteremia / diagnosis
  • Bacteremia / mortality*
  • Bacteremia / therapy
  • Cohort Studies
  • Female
  • Germany / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Program Evaluation
  • Referral and Consultation / statistics & numerical data*
  • Staphylococcal Infections / diagnosis
  • Staphylococcal Infections / mortality*
  • Staphylococcal Infections / therapy
  • Staphylococcus aureus*
  • Treatment Outcome