2025 Southeastern Residency Conference

Title: Outcomes Associated with Formal Infectious Diseases Consultation for Positive Blood Cultures with Staphylococci Other Than Staphylococcus aureus 


Authors: Kellee B. Geren, Brandon Hawkins, Mary Joyce Wingler, Jessica Ortwine, Samantha Walker, Helen Ding, Bryan Walker, Cami Andreini 


Objective: This study attempted to determine the impact of infectious diseases consultation on the clinical management, readmission, and mortality of patients with Staphylococcus lugdunensis, Staphylococcus pseudintermedius, or Staphylococcus schleiferi isolated from a blood culture. 


Self Assessment Question: True or False: Infectious diseases consultation in patients with S. lugdunensis, S. pseudintermedius, or S. schleiferi bacteremia resulted in a significant decrease in mortality or 30-day readmission.


Background: There is data suggesting infections caused by S. lugdunensis, S. pseudintermedius, and S. schleiferi may be associated with a higher acuity of illness. However, there is limited data defining the management of these organisms when isolated from a blood culture, as well as the impact of infectious disease consultation on mortality in these patients.


Methods: This was a multi-center, observational, retrospective cohort study that compared the clinical management and disease course of patients with (consult group) and without an infectious diseases consultation (no consult group). Adult patients admitted between January 1, 2014 and March 1, 2024, with blood cultures positive for one of the specified organisms were included. Patients were excluded if S. aureus was isolated at any point during admission or if they discharged, died, or transitioned to hospice prior to blood culture speciation. 


Results: The primary outcome composite of 90-day all-cause mortality from index blood culture or 30-day readmission due to bloodstream infections caused by S. lugdunensis, S. pseudintermedius, or S. schleiferi was 17.9% in the no consult group and 12.2% in the consult group (p = 0.308). Hospital length of stay was a median of 6.82 days in the no consult group compared to a median of 11.69 days in the consult group (p < 0.001). Thirty-day mortality was 12.8% in the no consult group versus 8.5% in the consult group versus (p = 0.379). 


Conclusion: In patients who received an infectious diseases consult, 90-day mortality, 30-day mortality, and 30-day readmission were numerically, but not significantly, lower. A larger study is needed to assess the impact of infectious diseases consultation on mortality for specific staphylococci.