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Background  Infectious disease (ID) consultations have been shown to increase adherence to guidelines and decrease mortality for patients with  Staphylococcus aureus  bacteremia (SAB). Here, we assessed the impact of a mandatory ID consultation policy for SAB.    Methods  We retrospectively reviewed all consecutive adult patients with SAB at two tertiary care teaching hospitals in Hamilton, ON, Canada. Mandatory ID consults for SAB were implemented on January 1 st  2012. We compared SAB cases in 2011 (control group) with those in 2012 (intervention group). Outcomes included adherence to the Infectious Diseases Society of America guidelines and patient outcomes.    Results  We reviewed 128 SAB cases in 2011 and 124 in 2012. The majority of  S. aureus  were methicillin-susceptible (97/128, 75.8 % in 2011 and 100/124, 80.6 % in 2012). ID involvement increased significantly from 93/128 (72.7 %) in 2011, to 103/124 (83.1 %) in 2012 (odds ratio [OR] 1.9, 95 % confidence interval [CI] 1.1–3.3,  p  = 0.047). There was also a significant decrease in the median time to ID involvement from 2 days to 1 ( p  = 0.001). In patients who survived the minimum treatment course (greater than 13 days), there was a significant improvement in adherence to IDSA guidelines in 2012 (65/102, 63.7 % vs. 77/96, 80.2 %; OR 2.3, 95 % CI 1.2–4.4,  p  = 0.01). Mortality and SAB relapse rates were similar in both groups.    Conclusions  Creating an automated ID consultation for SAB led to an increase in involvement of ID, a significant decrease in time to ID involvement, and better adherence to IDSA guidelines. The study was not sufficiently powered to detect significant changes in mortality and SAB relapse rates.    Electronic supplementary material  The online version of this article (doi:10.1186/s12879-015-1296-y) contains supplementary material, which is available to authorized users.

bmc infectious diseases

Management and outcomes in patients with Staphylococcus aureus bacteremia after implementation of mandatory infectious diseases consult: a before/after study