Impact of Infectious Disease Consultation on Clinical Management and Outcome of Patients with Bloodstream Infection: a Retrospective Cohort Study

The impact of consultation by infectious diseases (ID) physicians on management and outcomes of patients has not been determined in China. We assembled a retrospective cohort of 995 consecutive adult cases with bloodstream infections (BSI) in a major teaching hospital in China. Survival analysis was performed with Cox regression and the Kaplan-Meier curves. Among the 995 patients with BSI, 421 (42.3%) received consultation by ID physicians and 574 (57.7%) did not. ID consultation led to a significant lower hazard of death (hazard ratio [HR], 0.575; P < 0.05) and more appropriate antimicrobial use (95.0% vs 67.6%, P < 0.05). ID consultation was a protective factor among patients with BSI due to Gram-positive (HR, 0.551; P < 0.05) or Gram-negative (HR, 0.331; P < 0.05) bacteria. Multiple ID consultation was a protective factor (HR, 0.51; P < 0.05), while single consultation was not. In conclusion, ID consultation led to significant lower risk for patients with BSI and improved management. Multiple rather than single ID consultations reduced the hazard of death.