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Open Forum Infect Dis. 2016 Mar 1;3(2):ofw048. doi: 10.1093/ofid/ofw048. eCollection 2016 Mar.

The Impact of Infectious Disease Specialist Consultation for Staphylococcus aureus Bloodstream Infections: A Systematic Review.

Author information

1
Centre ofMolecular Inflammation Research, Department of Cancer Research and Molecular Medicine; Department of Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust; Mid-Norway Sepsis Research Center, Norwegian University of Science and Technology, Trondheim.
2
Departments ofCirculation and Medical Imaging; Mid-Norway Sepsis Research Center, Norwegian University of Science and Technology, Trondheim; Clinic of Anaesthesia and Intensive Care.
3
Centre ofMolecular Inflammation Research, Department of Cancer Research and Molecular Medicine; Mid-Norway Sepsis Research Center, Norwegian University of Science and Technology, Trondheim; Departments ofInfectious Diseases.
4
Department of Chronic Disease Epidemiology , Yale University School of Public Health , New Haven, Connecticut.
5
Mid-Norway Sepsis Research Center, Norwegian University of Science and Technology, Trondheim; Public Health, Norwegian University of Science and Technology, Trondheim; Endocrinology, St Olavs Hospital, Trondheim University Hospital, Norway.

Abstract

Staphylococcus aureus is a common cause of severe bloodstream infection. We performed a systematic review to assess whether consultation with infectious disease specialists decreased all-cause mortality or rate of complications of S aureus bloodstream infections. The review also assessed parameters associated with the quality of management of the infection. We searched for eligible studies in PubMed, Embase, Scopus, and clinical trials.gov as well as the references of included studies. We identified 22 observational studies and 1 study protocol for a randomized trial. A meta-analysis was not performed because of the high risk of bias in the included studies. The outcomes are reported in a narrative review. Most included studies reported survival benefit, in the adjusted analysis. Recommended management strategies were carried out significantly more often among patients seen by an infectious disease specialist. Trials, such as cluster-randomized controlled trials, can more validly assess the studies at low risk of bias.

KEYWORDS:

Staphylococcus aureus; bloodstream infection; infectious disease specialist consultation

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