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Development, impact and outcomes of the Hull Bacteraemia Service.

BACKGROUND
Bacteraemia is a significant cause of mortality and healthcare expenditure. Evidence suggests that consultation by an infection specialist may improve outcomes.


AIM
To review the characteristics and outcomes of patients seen by a newly implemented bacteraemia service.


METHODS
Retrospective review of data collected at time of consultation. Economic analyses and benchmarking of outcomes were also performed.


RESULTS
One hundred and fifty-one patients were seen by the service over an 18-month period. Staphylococcus aureus was the most common isolate and central venous lines the most common source. Antibiotics were changed and additional investigations suggested in 62% and 61% of patients, respectively. The 30-day mortality was 19%. Implementation and delivery of the service over the 18-month study period cost pound 22,663 (pound 15,109 per year). The cost per change in antibiotic prescription was pound 244. The cost per 'near-miss' detected was pound 1193. Overall mortality was no higher and possibly lower than in published studies.


CONCLUSION
We believe that this model of care may be suitable for the management of patients with bacteraemia. A study assessing the cost-effectiveness of this approach is required.