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For tough drug-resistant infections, specialists save lives

Infectious disease specialists helped cut the 30-day death rate of patients with tough-to-treat, drug-resistant infections by more than half, report researchers.

“The research emphasizes the positive influence infectious diseases physicians have on patient care and outcomes,” says Jason P. Burnham, the study’s first author and an instructor in medicine at Washington University School of Medicine in St. Louis. “These infections are becoming more common and occur in hospitals and the community. It is crucial to have infectious diseases experts on hand to treat these increasingly difficult drug-resistant infections.

Researchers reviewed records from 2006 to 2015 for 4,200 patients with multidrug-resistant infections treated at Barnes-Jewish Hospital. The infections studied included the bacteria S. aureus and Enterobacteriaceae, the latter of which is a large family of bacteria that includes Salmonella and Escherichia coli.

Patients with Enterobacteriaceae infections who received treatment from infectious diseases specialists experienced a 59 percent decrease in 30-day mortality, while those infected with S. aureus had a 52 percent reduction. For patients suffering from simultaneous, drug-resistant infections, the 30-day mortality dropped 49 percent.

Additionally, these patients were more likely to be alive a year later. Infectious diseases physicians treating initial S. aureus and Enterobacteriaceae infections in patients contributed to a 27 percent and 26 percent decrease, respectively, in one-year mortality rates.

Lay off the antibiotics for these small infections?

Researchers also studied hospital readmission rates and found that for drug resistant Enterobacteriaceae infections, 30-day readmissions of any cause dropped by 26 percent when an infectious diseases physician was involved in the patient’s care during the initial infection.

Small sample sizes of certain other drug-resistant infections limited the researchers’ ability to determine whether infectious diseases specialists affected these patients’ outcomes.

“With the results of this study, we know how critical it is for infectious diseases specialists to participate in the care of patients with drug-resistant infections,” Burnham says.

The researchers report their findings in the journal Open Forum Infectious Diseases. Marin Kollef, a professor of medicine and director of the medical intensive care unit and respiratory care services at Barnes-Jewish Hospital, is the study’s senior author.

Support for this work came from the Foundation for Barnes-Jewish Hospital, Washington University Institute of Clinical and Translational Sciences (ICTS), and the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH).

Source: Washington University in St. Louis

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