Comparison of the management and outcome of Staphylococcus aureus bacteraemia in children, preintroduction and postintroduction of an infectious disease consult service
| Quality indicator | Pre-IDC group N=30 episodes (%) | IDC group N=36 episodes (%) | p Value |
|---|---|---|---|
| Median time to infectious diseases review in days (IQR) | N=4 3.5 (0.5–21.5) | N=34 2.0 (1.0–4.0) | NS |
| Repeat blood culture performed | 26 (86.7) | 32 (88.9) | NS |
| Time to repeat blood culture (h) | |||
| 0–48 | 20 | 18 | NS |
| 48–96 | 8 | 13 | NS |
| >96 | 1 | 1 | NS |
| Repeat blood culture positive (h) | |||
| 0–48 | 6 | 6 | NS |
| 48–96 | 3 | 4 | NS |
| >96 | 0 | 0 | NS |
| Echocardiogram performed | |||
| Yes | 10 (33.3) | 29 (80.6) | 0.0001 |
| No | 20 (66.7) | 7 (19.4) | |
| β-Lactam therapy | 27 (90.0) | 34 (94.4) | NS |
| MSSA | 25 (92.6) | 33 (97.1) | |
| Removable focus of infection | 7 (23.3) | 22 (43.9) | 0.003 |
| Focus removed | 6 (85.7) | 21 (95.5) | NS |
| Median time to removal in days (IQR) | 2.0 (2.0–2.0) | 3.0 (1.0–18.0) | NS |
| Median time to appropriate antibiotics in days (IQR) | 0.0 (0) | 0.0 (0) | NS |
| Median duration of intravenous antibiotics in days (IQR) | 13.5 (7.0–21.0) | 18.0 (15.0–29.0) | 0.035 |
| Median duration of intravenous and/or oral antibiotics in days (IQR) | 20.5 (16.0–42) | 19.0 (15.0–29.5) | NS |
| Complicated infection | N=15 episodes Days (IQR) | N=19 episodes Days (IQR) | |
| Median duration of intravenous antibiotics | 14.0 (6.0–21.0) | 22 (15.0–39.0) | 0.02 |
| Median duration of intravenous or oral antibiotics | 19.0 (17.0–43.0) | 27.0 (16.0–39.0) | NS |
| Median duration of intravenous antibiotics if repeat blood culture positive | 13.0 (6.0–14.0) | 19.0 (15.0–27.0) | 0.007 |
| Met standard recommendation of 28 days intravenous antibiotics (%) | 2 (13.3) | 8 (42.1) | NS |
| Uncomplicated infection | N=15 episodes Days (IQR) | N=17 episodes Days (IQR) | |
| Median duration of intravenous antibiotics | 13.0 (7.0–22.0) | 15.0 (14.0–21.0) | NS |
| Median duration of intravenous or oral antibiotics (IQR) | 22.0 (14.0–32.0) | 18.0 (14.0–29.0) | NS |
| Met standard recommendation of 14 days (%) | 7 (46.7) | 13 (68.4) | NS |
| Outcomes | N=30 episodes Days (IQR) | N=36 episodes Days (IQR) | |
| Median duration of hospital admission | |||
| Total | 14.0 (6.0–42.0) | 16.5 (7.5–58) | NS |
| Complicated | 20.0 (6.0–49.0) | 25.0 (8.0–88.0) | NS |
| Uncomplicated | 7.0 (3.0–22.0) | 11.0 (6.0–36.0) | NS |
| SAB recorded in discharge summary | 24 (80.0) | 29 (82.9) | NS |
| Secondary infection detected | 1 | 3 | NS |
| Outcomes 30-day post-SAB | |||
| Death | 0 | 3 | NS |
| Recurrence | 0 | 0 | NS |
| Outcomes 30–90 days post-SAB | |||
| Death | 2 | 0 | NS |
| Recurrence | 2 | 1 | NS |
Mortality was analysed per patient (only the first episode was analysed).
IDC, infectious diseases consultation; NS, non-significant; SAB, Staphylococcus aureus bacteraemia.