Hospital patients with a MRSA infection require an infectious disease specialist

ID consult


If you’re a hospital patient under the care of a GP and have a MRSA infection, your chance of dying or being sent to hospice within a month is just over 23% – that’s almost 1 in every 4 patients. And further, within the first year of a MRSA infection that risk of mortality goes up to 44% – approaching 1 in every 2 patients.

But here’s the crucial bit: You can cut the risk of death in the first month by more than half; and the 1-year mortality figure by 13% – if you involve an infectious disease specialist in your care (in addition to your primary care doctor).

That’s the new and important finding by researchers at the Washington University School of Medicine in St. Louis, Missouri, in their 10-year retrospective study involving 4,214 adult patients in 13 academic medical center hospitals (they have sicker patients) in and around St. Louis.

In addition to the MRSA numbers, they also found that an ID consultation was associated with similar reductions in 30-day and 1-year mortality for drug-resistant Enterobacteriaceae infections (a family of microbes that includes E. coli and Salmonella) and for drug-resistant polymicrobial infections – infections caused by more than one bug.

Lead author of the study, Jason Burnham, MD, offered his perspective in an interview with Consumer Reports: If there were a medicine that had such a dramatic effect “every patient would be on it.”

He explains why you should be seen by an infectious disease doctor:

They do more than simply suggest that a particular antibiotic would work well for particular bacteria. While a nonspecialist can, for example, write you a prescription for an infection you pick up in the hospital, an infectious-disease doctor can help you launch a more comprehensive treatment plan – using multiple antibiotics in combination when needed, draining abscesses where infections can hide, removing infected central lines, checking for pernicious complications such as endocarditis (an infection of the heart valves), and monitoring you for potential side effects to potent antibiotics.

But there’s a problem of invisibilty.

As patient advocate Lisa McGiffert told Consume Reports, people with resistant infections often “don’t know to ask for a specialist…. [as they] probably don’t even know these kinds of doctors exist.” But “[i]f you have a heart condition, you’re going to want a cardiologist. This is the same kind of thing.”

And so asking for a specialist, McGiffert says, could “make a difference in a person living or dying.”












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