Skip to main content
Top
Published in: Infection 1/2019

01-02-2019 | Original Paper

Infectious disease services: a survey from four university hospitals in Germany

Authors: Siegbert Rieg, Florian Hitzenbichler, Stefan Hagel, Isabelle Suarez, Florian Kron, Bernd Salzberger, Mathias Pletz, Winfried V. Kern, Gerd Fätkenheuer, Norma Jung

Published in: Infection | Issue 1/2019

Login to get access

Abstract

Purpose

Involvement of infectious disease (ID) specialists in the care of hospitalized patients with infections through consultation services improves the quality of care and the outcome of patients. This survey aimed to describe activities and utilization of ID consultations at four German tertiary care hospitals.

Methods

A 1-month (March 2016) retrospective cross-sectional study at four university hospitals (Freiburg, Jena, Cologne and Regensburg) was performed. Only ID consultations with written documentation and bedside patient evaluation were included. Consultations were analyzed with regard to requesting departments, infections, case severity, and diagnostic and therapeutic recommendations.

Results

In the study period, 638 ID consultations were performed in 479 patients—corresponding to 3–4 consultations per 100 inpatient cases. Patients were characterized by a high disease complexity—the mean case mix index in patients with consultation was 10.1 compared to 1.6 for all patients. ID consultations were requested by many different specialties, with approximately half of the requests coming from surgical disciplines. ID consultations resulted in revised diagnoses in 34% of the cases, provided recommendations for additional diagnostic procedures in 66%, and for modifications of antimicrobial regimens in 70% of the cases.

Conclusions

Infectious disease consultations were requested for patients with severe and complicated diseases and resulted in recommendations that highly impacted the diagnostic work-up and therapeutic management of patients. The results of this survey may help to estimate requirements for establishment of such services in Germany.
Appendix
Available only for authorised users
Literature
1.
go back to reference Rieg S, Kupper MF. Infectious diseases consultations can make the difference: a brief review and a plea for more infectious diseases specialists in Germany. Infection. 2016;44:159–66.CrossRefPubMed Rieg S, Kupper MF. Infectious diseases consultations can make the difference: a brief review and a plea for more infectious diseases specialists in Germany. Infection. 2016;44:159–66.CrossRefPubMed
2.
go back to reference Patel M, Kunz DF, Trivedi VM, Jones MG, Moser SA, Baddley JW. Initial management of candidemia at an academic medical center: evaluation of the IDSA guidelines. Diagn Microbiol Infect Dis. 2005;52:29–34.CrossRefPubMed Patel M, Kunz DF, Trivedi VM, Jones MG, Moser SA, Baddley JW. Initial management of candidemia at an academic medical center: evaluation of the IDSA guidelines. Diagn Microbiol Infect Dis. 2005;52:29–34.CrossRefPubMed
3.
go back to reference Takakura S, Fujihara N, Saito T, Kimoto T, Ito Y, Iinuma Y, et al. Improved clinical outcome of patients with Candida bloodstream infections through direct consultation by infectious diseases physicians in a Japanese university hospital. Infect Control Hosp Epidemiol. 2006;27:964–8.CrossRefPubMed Takakura S, Fujihara N, Saito T, Kimoto T, Ito Y, Iinuma Y, et al. Improved clinical outcome of patients with Candida bloodstream infections through direct consultation by infectious diseases physicians in a Japanese university hospital. Infect Control Hosp Epidemiol. 2006;27:964–8.CrossRefPubMed
4.
go back to reference Vogel M, Schmitz RP, Hagel S, Pletz MW, Gagelmann N, Scherag A, et al. Infectious disease consultation for Staphylococcus aureus bacteremia—a systematic review and meta-analysis. J Infect. 2016;72:19–28.CrossRefPubMed Vogel M, Schmitz RP, Hagel S, Pletz MW, Gagelmann N, Scherag A, et al. Infectious disease consultation for Staphylococcus aureus bacteremia—a systematic review and meta-analysis. J Infect. 2016;72:19–28.CrossRefPubMed
5.
go back to reference Goto M, Schweizer ML, Vaughan-Sarrazin MS, Perencevich EN, Livorsi DJ, Diekema DJ, et al. Association of evidence-based care processes with mortality in Staphylococcus aureus Bacteremia at Veterans Health Administration Hospitals, 2003–2014. JAMA Intern Med. 2017;177:1489–97.CrossRefPubMedPubMedCentral Goto M, Schweizer ML, Vaughan-Sarrazin MS, Perencevich EN, Livorsi DJ, Diekema DJ, et al. Association of evidence-based care processes with mortality in Staphylococcus aureus Bacteremia at Veterans Health Administration Hospitals, 2003–2014. JAMA Intern Med. 2017;177:1489–97.CrossRefPubMedPubMedCentral
6.
go back to reference Schmitt S, McQuillen DP, Nahass R, Martinelli L, Rubin M, Schwebke K, et al. Infectious diseases specialty intervention is associated with decreased mortality and lower healthcare costs. Clin Infect Dis. 2014;58:22–8.CrossRefPubMed Schmitt S, McQuillen DP, Nahass R, Martinelli L, Rubin M, Schwebke K, et al. Infectious diseases specialty intervention is associated with decreased mortality and lower healthcare costs. Clin Infect Dis. 2014;58:22–8.CrossRefPubMed
7.
go back to reference Pulcini C, Botelho-Nevers E, Dyar OJ, Harbarth S. The impact of infectious disease specialists on antibiotic prescribing in hospitals. Clin Microbiol Infect. 2014;20:963–72.CrossRefPubMed Pulcini C, Botelho-Nevers E, Dyar OJ, Harbarth S. The impact of infectious disease specialists on antibiotic prescribing in hospitals. Clin Microbiol Infect. 2014;20:963–72.CrossRefPubMed
8.
go back to reference Rieg S, Kupper MF. Impact of an infectious diseases consultation service on the quality of care and the survival of patients with infectious diseases. Z Evid Fortbild Qual Gesundhwes. 2015;109:500–10.CrossRefPubMed Rieg S, Kupper MF. Impact of an infectious diseases consultation service on the quality of care and the survival of patients with infectious diseases. Z Evid Fortbild Qual Gesundhwes. 2015;109:500–10.CrossRefPubMed
9.
go back to reference Sasikumar M, Boyer S, Remacle-Bonnet A, Ventelou B, Brouqui P. The value of specialist care-infectious disease specialist referrals-why and for whom? A retrospective cohort study in a French tertiary hospital. Eur J Clin Microbiol Infect Dis. 2017;36:625–33.CrossRefPubMed Sasikumar M, Boyer S, Remacle-Bonnet A, Ventelou B, Brouqui P. The value of specialist care-infectious disease specialist referrals-why and for whom? A retrospective cohort study in a French tertiary hospital. Eur J Clin Microbiol Infect Dis. 2017;36:625–33.CrossRefPubMed
10.
go back to reference Kern WV, Fatkenheuer G, Tacconelli E, Ullmann A. Infectious diseases as a clinical specialty in Germany and Europe. Z Evid Fortbild Qual Gesundhwes. 2015;109:493–9.CrossRefPubMed Kern WV, Fatkenheuer G, Tacconelli E, Ullmann A. Infectious diseases as a clinical specialty in Germany and Europe. Z Evid Fortbild Qual Gesundhwes. 2015;109:493–9.CrossRefPubMed
11.
go back to reference Livorsi DJ, Heintz B, Jacob JT, Krein SL, Morgan DJ, Perencevich EN. Audit and feedback processes among antimicrobial stewardship programs: a survey of the society for healthcare epidemiology of America research network. Infect Control Hosp Epidemiol. 2016;37:704–6.CrossRefPubMed Livorsi DJ, Heintz B, Jacob JT, Krein SL, Morgan DJ, Perencevich EN. Audit and feedback processes among antimicrobial stewardship programs: a survey of the society for healthcare epidemiology of America research network. Infect Control Hosp Epidemiol. 2016;37:704–6.CrossRefPubMed
12.
go back to reference Yinnon AM. Whither infectious diseases consultations? Analysis of 14,005 consultations from a 5-year period. Clin Infect Dis 2001;33:1661–7.CrossRefPubMed Yinnon AM. Whither infectious diseases consultations? Analysis of 14,005 consultations from a 5-year period. Clin Infect Dis 2001;33:1661–7.CrossRefPubMed
13.
go back to reference Ingram PR, Cheng AC, Murray RJ, Blyth CC, Walls T, Fisher DA, et al. What do infectious diseases physicians do? A 2-week snapshot of inpatient consultative activities across Australia, New Zealand and Singapore. Clin Microbiol Infect. 2014;20:O737–44.CrossRefPubMed Ingram PR, Cheng AC, Murray RJ, Blyth CC, Walls T, Fisher DA, et al. What do infectious diseases physicians do? A 2-week snapshot of inpatient consultative activities across Australia, New Zealand and Singapore. Clin Microbiol Infect. 2014;20:O737–44.CrossRefPubMed
14.
go back to reference Schlesinger Y, Paltiel O, Yinnon AM. Analysis and impact of infectious disease consultations in a general hospital. J Hosp Infect. 1998;40:39–46.CrossRefPubMed Schlesinger Y, Paltiel O, Yinnon AM. Analysis and impact of infectious disease consultations in a general hospital. J Hosp Infect. 1998;40:39–46.CrossRefPubMed
15.
go back to reference Sexton DJ, Corey GR, Ingram CW, Morris VM, Haywood HB III. Consultation in university-based and community-based infectious disease practices: a prospective study. Clin Infect Dis. 1995;20:391–3.CrossRefPubMed Sexton DJ, Corey GR, Ingram CW, Morris VM, Haywood HB III. Consultation in university-based and community-based infectious disease practices: a prospective study. Clin Infect Dis. 1995;20:391–3.CrossRefPubMed
16.
go back to reference de La BA, Boutemy J, Thibon P, Michon J, Verdon R, Cattoir V. Clinical benefit of infectious diseases consultation: a monocentric prospective cohort study. Infection. 2012;40:501–7.CrossRef de La BA, Boutemy J, Thibon P, Michon J, Verdon R, Cattoir V. Clinical benefit of infectious diseases consultation: a monocentric prospective cohort study. Infection. 2012;40:501–7.CrossRef
17.
go back to reference Fox BC, Imrey PB, Voights MB, Norwood S. Infectious disease consultation and microbiologic surveillance for intensive care unit trauma patients: a pilot study. Clin Infect Dis 2001;33:1981–9.CrossRefPubMed Fox BC, Imrey PB, Voights MB, Norwood S. Infectious disease consultation and microbiologic surveillance for intensive care unit trauma patients: a pilot study. Clin Infect Dis 2001;33:1981–9.CrossRefPubMed
18.
go back to reference Lemmen SW, Hafner H, Kotterik S, Lutticken R, Topper R. Influence of an infectious disease service on antibiotic prescription behavior and selection of multiresistant pathogens. Infection. 2000;28:384–7.CrossRefPubMed Lemmen SW, Hafner H, Kotterik S, Lutticken R, Topper R. Influence of an infectious disease service on antibiotic prescription behavior and selection of multiresistant pathogens. Infection. 2000;28:384–7.CrossRefPubMed
19.
go back to reference Hamandi B, Husain S, Humar A, Papadimitropoulos EA. Impact of infectious disease consultation on the clinical and economic outcomes of solid organ transplant recipients admitted for infectious complications. Clin Infect Dis 2014;59:1074–82.CrossRefPubMed Hamandi B, Husain S, Humar A, Papadimitropoulos EA. Impact of infectious disease consultation on the clinical and economic outcomes of solid organ transplant recipients admitted for infectious complications. Clin Infect Dis 2014;59:1074–82.CrossRefPubMed
20.
go back to reference Chirillo F, Scotton P, Rocco F, Rigoli R, Borsatto F, Pedrocco A, et al. Impact of a multidisciplinary management strategy on the outcome of patients with native valve infective endocarditis. Am J Cardiol 2013;112:1171–6.CrossRefPubMed Chirillo F, Scotton P, Rocco F, Rigoli R, Borsatto F, Pedrocco A, et al. Impact of a multidisciplinary management strategy on the outcome of patients with native valve infective endocarditis. Am J Cardiol 2013;112:1171–6.CrossRefPubMed
21.
go back to reference Baddour LM, Wilson WR, Bayer AS, Fowler VG Jr, Tleyjeh IM, Rybak MJ, et al. Infective endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications: a scientific statement for healthcare professionals from the american heart association. Circulation 2015;132:1435–86.CrossRefPubMed Baddour LM, Wilson WR, Bayer AS, Fowler VG Jr, Tleyjeh IM, Rybak MJ, et al. Infective endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications: a scientific statement for healthcare professionals from the american heart association. Circulation 2015;132:1435–86.CrossRefPubMed
22.
go back to reference Habib G, Lancellotti P, Antunes MJ, Bongiorni MG, Casalta JP, Del ZF, et al. 2015 ESC Guidelines for the management of infective endocarditis: the Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart J 2015;36:3075–128.CrossRefPubMed Habib G, Lancellotti P, Antunes MJ, Bongiorni MG, Casalta JP, Del ZF, et al. 2015 ESC Guidelines for the management of infective endocarditis: the Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart J 2015;36:3075–128.CrossRefPubMed
23.
go back to reference Osmon DR, Berbari EF, Berendt AR, Lew D, Zimmerli W, Steckelberg JM, et al. Diagnosis and management of prosthetic joint infection: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis. 2013;56:e1–25.CrossRefPubMed Osmon DR, Berbari EF, Berendt AR, Lew D, Zimmerli W, Steckelberg JM, et al. Diagnosis and management of prosthetic joint infection: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis. 2013;56:e1–25.CrossRefPubMed
24.
go back to reference Berbari EF, Kanj SS, Kowalski TJ, Darouiche RO, Widmer AF, Schmitt SK, et al. 2015 infectious diseases society of America (IDSA) clinical practice guidelines for the diagnosis and treatment of native vertebral osteomyelitis in adults. Clin Infect Dis 2015;61:e26–46.CrossRefPubMed Berbari EF, Kanj SS, Kowalski TJ, Darouiche RO, Widmer AF, Schmitt SK, et al. 2015 infectious diseases society of America (IDSA) clinical practice guidelines for the diagnosis and treatment of native vertebral osteomyelitis in adults. Clin Infect Dis 2015;61:e26–46.CrossRefPubMed
25.
go back to reference Patterson TF, Thompson GR III, Denning DW, Fishman JA, Hadley S, Herbrecht R, et al. Practice guidelines for the diagnosis and management of aspergillosis: 2016 update by the infectious diseases society of America. Clin Infect Dis 2016;63:e1–60.CrossRefPubMedPubMedCentral Patterson TF, Thompson GR III, Denning DW, Fishman JA, Hadley S, Herbrecht R, et al. Practice guidelines for the diagnosis and management of aspergillosis: 2016 update by the infectious diseases society of America. Clin Infect Dis 2016;63:e1–60.CrossRefPubMedPubMedCentral
26.
go back to reference Pappas PG, Kauffman CA, Andes DR, Clancy CJ, Marr KA, Ostrosky-Zeichner L, et al. Clinical practice guideline for the management of candidiasis: 2016 update by the infectious diseases society of America. Clin Infect Dis 2016;62:e1–50.CrossRefPubMed Pappas PG, Kauffman CA, Andes DR, Clancy CJ, Marr KA, Ostrosky-Zeichner L, et al. Clinical practice guideline for the management of candidiasis: 2016 update by the infectious diseases society of America. Clin Infect Dis 2016;62:e1–50.CrossRefPubMed
27.
go back to reference Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Intensiv Care Med. 2017;43:304–77.CrossRef Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Intensiv Care Med. 2017;43:304–77.CrossRef
Metadata
Title
Infectious disease services: a survey from four university hospitals in Germany
Authors
Siegbert Rieg
Florian Hitzenbichler
Stefan Hagel
Isabelle Suarez
Florian Kron
Bernd Salzberger
Mathias Pletz
Winfried V. Kern
Gerd Fätkenheuer
Norma Jung
Publication date
01-02-2019
Publisher
Springer Berlin Heidelberg
Published in
Infection / Issue 1/2019
Print ISSN: 0300-8126
Electronic ISSN: 1439-0973
DOI
https://doi.org/10.1007/s15010-018-1191-8

Other articles of this Issue 1/2019

Infection 1/2019 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.