Related Experiment Video
Updated: Sep 7, 2025
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Increasing Pediatric Infectious Diseases Consultation Rates for Staphylococcus aureus Bacteremia
Oren Gordon1, Nadine Peart Akindele1, Christina Schumacher2
1Division of Infectious Diseases, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Md.
Insights
Implementing an electronic advisory comment significantly boosted infectious disease consultations for pediatric Staphylococcus aureus bacteremia (SAB). This intervention reduced SAB recurrence, improving patient outcomes in pediatric care.
Area of Science:
- Pediatric Infectious Diseases
- Quality Improvement in Healthcare
- Bacteremia Management
Background:
- Staphylococcus aureus bacteremia (SAB) in children leads to severe outcomes, including recurrence.
- Infectious disease consultation (IDC) improves outcomes in adult SAB but is less studied in pediatrics.
- Optimizing IDC for pediatric SAB is crucial for reducing morbidity and mortality.
Purpose of the Study:
- To increase the rate of infectious disease consultations (IDC) for pediatric Staphylococcus aureus bacteremia (SAB) events.
- To evaluate the impact of an electronic advisory comment on IDC rates and SAB recurrence.
- To assess the feasibility of a low-resource intervention for improving pediatric SAB management.
Main Methods:
- A quality improvement project was conducted at a quaternary pediatric medical center.
- An electronic advisory comment supporting IDC for SAB was implemented in September 2020.
- Statistical process control charts monitored IDC rates; SAB recurrences were analyzed pre- and post-intervention.
Main Results:
- IDC rates for pediatric SAB increased from 61% (30/49) to 96% (22/23) post-intervention.
- The ratio of SAB events with IDC versus without IDC improved significantly (1.4 to 14).
- No SAB recurrences were observed after the intervention; all prior recurrences (8%) lacked initial IDC (P = 0.0002).
Conclusions:
- An electronic advisory comment is an effective, low-resource strategy to increase pediatric IDC for SAB.
- This intervention significantly reduced SAB recurrence, enhancing patient care.
- The approach is recommended for consideration in other pediatric centers to optimize SAB management.
Introduction:
Staphylococcus aureus bacteremia (SAB) in children is associated with significant mortality and morbidity, including recurrent bacteremia. Infectious disease consultation (IDC) improves SAB outcomes in adult patients. However, increasing IDC and impact for pediatric patients with SAB is not well described.
Methods:
This quality improvement project aimed to increase IDC for SAB events at a quaternary pediatric medical center. First, we evaluated the local practices regarding pediatric SAB and engaged stakeholders (July 2018-August 2020). We added an advisory comment supporting IDC for SAB to all blood culture results in September 2020. Using statistical process control charts, we monitored the number of SAB events with IDC before a SAB event without IDC. Finally, we evaluated SAB recurrences before and after initiating the advisory comment.
Results:
In the baseline period, 30 of 49 (61%) SAB events received an IDC with a mean of 1.4 SAB events with IDC before a SAB event without IDC. Postintervention, 22 of 23 (96%) SAB events received IDC with a mean of 14 events with IDC before 1 event without IDC. The SAB recurrence rate was 8%, with 6 events in 4 children; none of the index cases resulting in recurrence received an IDC (P = 0.0002), and all occurred before any intervention.
Conclusions:
An electronic advisory comment supporting IDC for SAB significantly increased the rate of pediatric IDC with no further SAB recurrence episodes following intervention. This low-resource intervention may be considered in other pediatric centers to optimize SAB management.
Related Concept Videos
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:26Urine Studies II: Urine Culture and Sensitivity Test
01:20Sputum Studies II: Culture and Sensitivity
Sputum culture and sensitivity is a medical procedure used to diagnose bacterial infections in the respiratory tract and select the most appropriate antibiotics for treatment. This process involves analyzing sputum samples of thick and opaque secretions produced in the lungs and airways. These samples are collected from patients and then sent to the laboratory for analysis.
The test can identify various pathogens responsible for respiratory infections, including Streptococcus,...
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
01:26Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.