Early Infectious Disease Consultations in Staphylococcus Aureus Bacteremia

Study Overview
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Brief Summary
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The primary objective is to determine if early infectious disease (ID) consultation (defined as within 48 hours of a positive blood culture) will reduce mortality rates from Staphylococcus aureus bacteremia (SAB). This study will also determine if such consultations could reduce the duration of hospitalisation, recurrence and financial costs in patients with this infection.

Detailed Description
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Bacteremia is a serious manifestation of Staphylococcus aureus infection with an attributable mortality as high as 25% in MRSA bacteremia. More than a third of patients end up with complications such as endocarditis, osteomyelitis or pneumonia. Overall the outcome of patients with respect to mortality or recurrence is better in patients who have an eradicable focus and have received an appropriate antibiotic dose and duration. Also complicated bacteremia is more common in patients with persistent bacteremia or fever prosthetic device new murmur skin findings of a systemic infection Based on this evidence, an ID consultation could improve the outcomes of patients with SAB by Advising adequate antibiotic dosage and duration Sourcing out and counselling eradication of any focus of infection

Official Title
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Early Infectious Disease Consultation for Better Outcomes From Staphylococcus Aureus Bacteremia

Conditions
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Staphylococcus Aureus Bacteremia

Intervention / Treatment
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* Other: infectious disease specialist consultation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All inpatients at the National University Hospital with Staphylococcus aureus (both methicillin sensitive and methicillin resistant) bacteremia isolated within the defined time period Exclusion Criteria: Patients who died or were discharged before the notification from the laboratory Neonates Polymicrobial bacteremia

Ages Eligible for Study
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Minimum Age: 1 Month

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: ID<br>Patients receiving an early Infectious disease consultation ( within first 48 hours of a positive blood culture) | Other: infectious disease specialist consultation<br>* Randomised trial to determine the utility of an early Infectious disease Consultation in Staphylococcus aureus bacteremic patients ( in the first 48 hours of a positive blood culture)<br>* Other names: Health Services;|
| No Intervention: NO ID<br>Includes those patients who do not receive an Infectious disease consultation in the first 48 hours | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| mortality |  | 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| recurrence |  | 2 year | 
| duration of hospitalisation |  | 1 year | 
| financial costs of hospitalisation |  | 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Staphylococcus aureus, Bacteremia, Outcome, Mortality, Recurrence, Infectious Diseases specialists