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日本癌症中心的传染病专家会诊:776 例回顾性研究。

Infectious disease specialist consultations in a Japanese cancer center: a retrospective review of 776 cases.

机构信息

Division of Infectious Diseases, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi, Sunto-gun, Shizuoka, 411-8777, Japan.

Department of Infection Control and Prevention, Tokyo Medical and Dental University Hospital, Bunkyo-ku, Tokyo, Japan.

出版信息

BMC Health Serv Res. 2020 Jun 3;20(1):500. doi: 10.1186/s12913-020-05380-6.

Abstract

BACKGROUND

Little is known about the impact of infectious disease (ID) consultations on the management of patients with cancer. This study aimed to describe the consultation services provided by ID specialists to all departments in a comprehensive cancer center in Japan.

METHODS

We conducted a retrospective review of ID consultations with adult patients at a comprehensive cancer center in Japan from April 2017 to March 2018.

RESULTS

During the study period, 776 patients with cancer had an ID consultation. Of these, 414 (53.4%) were hospital inpatients. Reasons for the ID consultation comprised clinical management (n = 481, 62.0%), immunization (n = 272, 35.1%), and infection control (n = 23, 3.0%). Of the 474 ID consultations for diagnostic purposes, the most frequent condition was fever or elevated inflammatory markers of unknown origin (n = 125, 26.4%). The most frequent diagnoses after the diagnostic ID consultation were hepatobiliary infections (n = 97, 22.4%), respiratory infections (n = 89, 20.618.8%), and intra-abdominal infections (n = 71, 16.4%). The commonest reasons for immunization consultations were to prevent seasonal influenza (n = 193, 71.0%) and post-splenectomy vaccination (n = 58, 21.3%). The commonest reasons for infection control consultations were suspected tuberculosis or contact with tuberculosis (n = 11, 47.8%) and herpes zoster infection (shingles) (n = 7, 30.4%).

CONCLUSIONS

ID specialists play an important role in the clinical management of patients with cancer. ID physicians who work in cancer centers need to be specialized in treating IDs, diagnosing the causes of fevers of unknown origin, and controlling infection.

摘要

背景

关于传染病(ID)咨询对癌症患者管理的影响知之甚少。本研究旨在描述日本综合癌症中心的 ID 专家为所有科室提供的咨询服务。

方法

我们对 2017 年 4 月至 2018 年 3 月在日本综合癌症中心接受 ID 咨询的成年癌症患者进行了回顾性分析。

结果

在研究期间,776 例癌症患者接受了 ID 咨询。其中,414 例(53.4%)为住院患者。ID 咨询的原因包括临床管理(n=481,62.0%)、免疫接种(n=272,35.1%)和感染控制(n=23,3.0%)。474 次 ID 诊断咨询中,最常见的情况是发热或不明原因的炎症标志物升高(n=125,26.4%)。诊断性 ID 咨询后的最常见诊断为肝胆感染(n=97,22.4%)、呼吸道感染(n=89,20.6%)和腹腔内感染(n=71,16.4%)。免疫接种咨询最常见的原因是预防季节性流感(n=193,71.0%)和脾切除术后疫苗接种(n=58,21.3%)。感染控制咨询最常见的原因是疑似肺结核或接触肺结核(n=11,47.8%)和带状疱疹感染(带状疱疹)(n=7,30.4%)。

结论

ID 专家在癌症患者的临床管理中发挥着重要作用。在癌症中心工作的 ID 医生需要专门治疗感染性疾病、诊断不明原因发热的原因和控制感染。

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