1233. An Automated e-mail Notification Systemic to Infectious Disease Specialists and Effect on the Management of Staphylococcal aureus Bacteremia in a Community Hospital setting
Session: Poster Abstract Session: Healthcare Epidemiology: MSSA, MRSA and Other Gram Positive Infections
Friday, October 5, 2018
Room: S Poster Hall
Posters
  • finalstaphposter.pdf (538.3 kB)
  • Background:

    Staphylococcus aureus is the leading cause of community and healthcare associated bacteremia and carries a high burden with a substantial mortality, ranging from 20-40 %. Evidence suggests infectious disease (ID) consultation improves mortality and adherence to the Infectious Diseases Society of America (IDSA) guidelines. Due to complications from a lack of ID consultation, a notification system consisting of automated e-mails to ID providers was implemented. The objective of this study was to review the impact of the automatic notification to ID consultants with positive blood culture results in a community hospital system.

    Methods:

    Cases of staphylococcus aureus bacteremia were identified from the microbiology database by at least one positive blood culture. The automated e-mail notification system was implemented in December 2014. ID providers were encouraged to verbally contact primary providers for positive results. Cases of bacteremia prior to implementation of the automated notification system were compared to those post-intervention. Patients under age 18 were excluded. Data gathered included mortality, re-admission rates, and compliance with IDSA guidelines.

    Results:

    There were no significant differences in inpatient mortality (9 vs. 18%, p=0.180). 30-day mortality between the two groups (18 vs 20%,p=0.815). The 30-day readmission rate among surviving patients was reduced by 50% (40% vs. 19%, p=0.014). Compliance with antibiotic duration in complicated bacteremia increased post-intervention (57% vs. 85%, p=0.04).

    Conclusion:

    An automatic notification to ID specialists reporting patients with Staphylococcus aureus bacteremia led to improved compliance with IDSA guidelines regarding antibiotic duration and reduced re-admission rates. There was no effect on overall mortality.

    Table 1- Patient demographics

    Pre Intervention (N=57)

    Post Intervention (N=60)

    p

    Average patient age (years)

    64.4

    62.2

    0.448

    Male

    63%

    63%

    1

    Immunosuppressed

    16%

    13%

    0.80

    Complicated bacteremia

    70%

    69%

    1

    Table 2 - Patient Outcomes

    Pre Intervention

    (N=57)

    Post Intervention

    (N=60)

    p

    Inpatient Mortality

    9%

    18%

    0.180

    30 day Mortality (%)

    18%

    20%

    0.815

    Readmitted within 30 days

    40%

    19%

    0.014

    Bedside ID Consult

    75%

    78%

    0.888

    Appropriate Antibiotic Duration

    -complicated bacteremia (>28 days)

    57%

    85%

    0.04

    Nicole Roe, DO1,2, Michael Wang, MD1,2 and Richard Douce, MD1,2, (1)Medicine, Lakeland Health, Saint Joseph, MI, (2)Medicine, Michigan State University College of Osteopathic Medicine, East Lansing, MI

    Disclosures:

    N. Roe, None

    M. Wang, None

    R. Douce, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.