{"id":27209,"date":"2025-01-21T04:10:00","date_gmt":"2025-01-20T20:10:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=27209"},"modified":"2025-01-21T06:01:51","modified_gmt":"2025-01-20T22:01:51","slug":"clin-infect-dis%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e6%84%9f%e6%9f%93%e7%a7%91%e5%8c%bb%e7%94%9f%e4%bc%9a%e8%af%8a%e4%b8%8e%e9%9d%a9%e5%85%b0%e9%98%b4%e6%80%a7%e8%8f%8c%e8%8f%8c%e8%a1%80","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=27209","title":{"rendered":"[Clin Infect Dis\u53d1\u8868\u8bba\u6587]\uff1a\u611f\u67d3\u79d1\u533b\u751f\u4f1a\u8bca\u4e0e\u9769\u5170\u9634\u6027\u83cc\u83cc\u8840\u75c7\u4f4f\u9662\u60a3\u8005\u7684\u75c5\u6b7b\u7387"},"content":{"rendered":"\n

Association Between Infectious Diseases Consultation and Mortality in Hospitalized Patients With Gram-negative Bloodstream Infection: A Retrospective Population-wide Cohort Study <\/h1>\n\n\n\n

Sean W X Ong,  Jin Luo,  Daniel J Fridman,  et al<\/h3>\n\n\n\n

Clinical Infectious Diseases<\/em>, Volume 79, Issue 4, 15 October 2024, Pages 855\u2013863, https:\/\/doi.org\/10.1093\/cid\/ciae282<\/a><\/h3>\n\n\n\n

Abstract<\/h2>\n\n\n\n

Objectives<\/p>\n\n\n\n

Data supporting routine infectious diseases (ID) consultation in gram-negative bloodstream infection (GN-BSI) are limited. We evaluated the association between ID consultation and mortality in patients with GN-BSI in a retrospective population-wide cohort study in Ontario using linked health administrative databases.<\/p>\n\n\n\n

Methods<\/p>\n\n\n\n

Hospitalized adult patients with GN-BSI between April 2017 and December 2021 were included. The primary outcome was time to all-cause mortality censored at 30 days, analyzed using a mixed effects Cox proportional hazards model with hospital as a random effect. ID consultation 1\u201310 days after the first positive blood culture was treated as a time-varying exposure.<\/p>\n\n\n\n

Results<\/p>\n\n\n\n

Of 30 159 patients with GN-BSI across 53 hospitals, 11 013 (36.5%) received ID consultation. Median prevalence of ID consultation for patients with GN-BSI across hospitals was 35.0% with wide variability (range 2.7%\u201376.1%, interquartile range 19.6%\u201341.1%). In total, 1041 (9.5%) patients who received ID consultation died within 30 days, compared to 1797 (9.4%) patients without ID consultation. In the fully adjusted multivariable model, ID consultation was associated with mortality benefit (adjusted hazard ratio [HR] 0.82, 95% confidence interval [CI] .77\u2013.88,\u00a0P<\/em>\u00a0< .0001; translating to absolute risk reduction of \u22123.8% or number needed to treat [NNT] of 27). Exploratory subgroup analyses of the primary outcome showed that ID consultation could have greater benefit in patients with high-risk features (nosocomial infection, polymicrobial or non-Enterobacterales infection, antimicrobial resistance, or non-urinary tract source).<\/p>\n\n\n\n

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Conclusions<\/p>\n\n\n\n

Early ID consultation was associated with reduced mortality in patients with GN-BSI. If resources permit, routine ID consultation for this patient population should be considered to improve patient outcomes.<\/p>\n","protected":false},"excerpt":{"rendered":"

Association Between Infectious Diseases Consultation an […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/27209"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=27209"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/27209\/revisions"}],"predecessor-version":[{"id":27602,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/27209\/revisions\/27602"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=27209"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=27209"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=27209"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}