Division of Infectious Diseases, Department of Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany.
Infectious Diseases Unit, University Hospital of Regensburg, Regensburg, Germany.
Infection. 2019 Feb;47(1):27-33. doi: 10.1007/s15010-018-1191-8. Epub 2018 Aug 17.
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.
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.
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.
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.
传染病（ID）专家通过咨询服务参与住院感染患者的治疗可提高护理质量和患者预后。本调查旨在描述德国四家三级护理医院的 ID 咨询活动和利用情况。
在四家大学医院（弗莱堡、耶拿、科隆和雷根斯堡）进行了为期一个月（2016 年 3 月）的回顾性横断面研究。仅纳入有书面记录和床边患者评估的 ID 咨询。分析了咨询的请求科室、感染、病例严重程度以及诊断和治疗建议。
在研究期间，对 479 名患者中的 638 次 ID 咨询进行了评估，每 100 例住院患者中约有 3-4 次咨询。患者疾病的复杂性很高，咨询患者的平均病例组合指数为 10.1，而所有患者的平均病例组合指数为 1.6。咨询请求来自许多不同的科室，其中约一半来自外科科室。34%的病例中对诊断进行了修订，66%的病例中建议进行额外的诊断程序，70%的病例中建议修改抗菌药物方案。
传染病咨询针对患有严重和复杂疾病的患者，其建议对患者的诊断和治疗管理产生了重大影响。本调查的结果可能有助于评估在德国建立此类服务的需求。
