Abstract
Purpose
The aim of this study was to describe the value of infectious disease specialist consultations for surgeons at comprehensive cancer centers.
Methods
A total of 151 cancer surgery inpatients were retrospectively assessed during a 12-month period. We focused on the characteristics of the infectious disease consultations from surgical departments: the referring surgical divisions, the referral phases, and the reasons for the infectious disease consultations.
Results
Three-quarters of all consultation requests were made after the day of surgery. Approximately, 60 % of these requests were made within 30 days after surgery for cancer. The reasons for the infectious disease consultations could be classified into three categories: diagnosis and management (54 %), management of established infections (44 %), and surgical antimicrobial prophylaxis (3 %). The most requested reason for consultations was the diagnosis and management of fever or elevated inflammatory markers of unknown etiology. Among the management of established infections, the antimicrobial management of surgical site infections was most frequently requested.
Conclusions
Many surgeons would prefer infectious disease specialists to assume a more direct role in the care of difficult or perplexing cases (such as fevers of unknown origin) while also maintaining a traditional relationship in which the consultant recommends antimicrobial agents during a perioperative period. Particularly at cancer centers where oncology specialists account for a significant proportion of the providers, the knowledge and skill of infectious disease physicians are valued.
Similar content being viewed by others
References
Granwehr BP, Kontoyiannis DP (2013) The impact of infectious diseases consultation on oncology practice. Curr Opin Oncol 25:353–359. doi:10.1097/CCO.0b013e3283622c32
Pongas G, Hamilos G, Rolston KV, Kontoyiannis DP (2012) Formal adult infectious disease specialist consultations in the outpatient setting at a comprehensive cancer center (1998–2008): diverse and impactful. Support Care Cancer 20:261–265. doi:10.1007/s00520-010-1065-9
Yinnon AM (2001) Whither infectious diseases consultations? Analysis of 14,005 consultations from a 5-year period. Clin Infect Dis 33:1661–1667. doi:10.1086/323760
Sipahi OR, Tasbakan M, Pullukcu H, Arda B, Yamazhan T, Mizrakci S, Senol S, Atalay S, Koseli D, Arsu G, Calik S, Sipahi H, Buke C, Ulusoy S (2007) Accuracy of consultations performed by infectious diseases trainees and factors associated with adherence to them. Int J Infect Dis 11:518–523. doi:10.1016/j.ijid.2007.02.003
Pavese P, Sellier E, Laborde L, Gennai S, Stahl JP, Francois P (2011) Requesting physicians’ experiences regarding infectious disease consultations. BMC Infect Dis 11:62. doi:10.1186/1471-2334-11-62
Sellier E, Pavese P, Gennai S, Stahl JP, Labarere J, Francois P (2010) Factors and outcomes associated with physicians’ adherence to recommendations of infectious disease consultations for inpatients. J Antimicrob Chemother 65:156–162. doi:10.1093/jac/dkp406
Gennai S, Francois P, Sellier E, Vittoz JP, Hincky-Vitrat V, Pavese P (2011) Prospective study of telephone calls to a hotline for infectious disease consultation: analysis of 7,863 solicited consultations over a 1-year period. Eur J Clin Microbiol Infect Dis 30:509–514. doi:10.1007/s10096-010-1111-z
Grupper M, Potasman I (2008) Formal adult infectious disease outpatient consultations: a retrospective 6-year survey. Infection 36:543–548. doi:10.1007/s15010-008-7397-4
Rush TJ (2001) The role of the infectious disease specialist in pancreatic surgery. Surg Clin N Am 81:647–650. doi:10.1016/S0039-6109(05)70150-X
Arbo MJ, Fine MJ, Hanusa BH, Sefcik T, Kapoor WN (1993) Fever of nosocomial origin: etiology, risk factors, and outcomes. Am J Med 95:505–512. doi:10.1016/0002-9343(93)90333-K
Borer A, Gilad J, Meydan N, Schlaeffer P, Riesenberg K, Schlaeffer F (2004) Impact of regular attendance by infectious disease specialists on the management of hospitalised adults with community-acquired febrile syndromes. Clin Microbiol Infect 10:911–916. doi:10.1111/j.1469-0691.2004.00964.x
Weinstein RA (1998) Nosocomial infection update. Emerg Infect Dis 4:416–420. doi:10.3201/eid0403.980320
Salerno SM, Hurst FP, Halvorson S, Mercado DL (2007) Principles of effective consultation: an update for the 21st-century consultant. Arch Intern Med 167:271–275. doi:10.1001/archinte.167.3.271
Petrak RM, Sexton DJ, Butera ML, Tenenbaum MJ, MacGregor MC, Schmidt ME, Joseph WP, Kemmerly SA, Dougherty MJ, Bakken JS, Curfman MF, Martinelli LP, Gainer RB (2003) The value of an infectious diseases specialist. Clin Infect Dis 36:1013–1017. doi:10.1086/374245
Conflict of interest
None
Disclosures
None
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kawamura, I., Kurai, H. Inpatient infectious disease consultations requested by surgeons at a comprehensive cancer center. Support Care Cancer 23, 3011–3014 (2015). https://doi.org/10.1007/s00520-015-2669-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00520-015-2669-x