Impact of early infectious diseases consultation on the management of central line-associated bloodstream infection: a propensity score weighting retrospective cohort study.

BACKGROUND

Central line-associated bloodstream infection (CLABSI) is an important healthcare-associated infection, particularly in the intensive care unit (ICU). This study aimed to investigate the impact of early infectious disease consultation (IDC) on the quality of care metrics of CLABSI in patients admitted to the ICU.

METHODS

Patients with CLABSI admitted to the ICU were included and divided into early IDC, and late or never IDC groups. The early IDC group indicated patients whose attending physician received IDC within 72 h of CLABSI onset. The main outcomes were the proportion of patients who received optimal targeted antibiotic treatment and catheter removal within 72 h of CLABSI onset. Propensity score analysis with the inverse probability of the treatment weighting method was used to compare the outcomes.

RESULTS

Among the 197 enrolled patients, 52 (26.4%) underwent early IDC and 145 (63.6%) did not. The early IDC group showed considerably higher proportions of catheter removal (76.9% versus 44.8%; adjusted odds ratio (OR): 3.70, 95% confidence interval (CI): 1.72-7.98; P = 0.001) than the late or never IDC group. The proportions of patients receiving optimal targeted antibiotic treatment were significantly higher in the early IDC group than in the late or never IDC group (67.3% versus 46.9%, adjusted OR: adjusted OR: 2.40, 95% CI: 1.17-4.91, P = 0.016)).

CONCLUSIONS

Early IDC was associated with improvement of the quality of care for patients with CLABSI in the ICU. This findings support the implementation of early IDC should be considered as an integral part of care of CLABSI in ICU patients.