Eur J Clin Microbiol Infect Dis (2015) 34:1589–1592 DOI 10.1007/s10096-015-2391-0
ARTICLE
A comparison of paediatric and adult infectious diseases consultations in Australia and New Zealand C. C. Blyth 1,2,3,4 & T. Walls 5 & A. C. Cheng 6,7 & R. J. Murray 8,9 & D. A. Fisher 10,11 & P. R. Ingram 12,13 & J. S. Davis 14,15 & on behalf of the Australasian Society for Infectious Diseases Clinical Research Network and the Australian New Zealand Paediatric Infectious Diseases Research Network
Received: 3 March 2015 / Accepted: 15 April 2015 / Published online: 29 April 2015 # Springer-Verlag Berlin Heidelberg 2015
Abstract The objective of this paper is to describe paediatric infectious diseases consultations across Australia and New Zealand. We surveyed infectious diseases physicians at 51 hospitals over a period of 2 weeks in 2012. Compared with adult consults, paediatric consults were more frequently received from general paediatricians/physicians and intensive care, yet less frequently from surgeons and emergency. Respiratory, skin/soft tissue and bone/joint infections were the most frequent consultations in children. These data demonstrate the breadth of formal infectious diseases consults in children. Differences between paediatric and infectious diseases consultations need to be considered when planning both paediatric and adult physician training and future curriculum development.
* T. Walls [email protected]
Introduction Despite the increasing demand for advice offered by infectious diseases (ID) physicians, there are few data on the activities of ID physicians, particularly physicians consulting on children [1]. We describe the formal inpatient-related activities undertaken by ID physicians in Australia and New Zealand, focusing on paediatric ID consults.
Methods We conducted a prospective survey of ID physician-related activities over a fortnight in August (winter) 2012. We have
8
Department of Microbiology, PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Perth, Australia
9
Department of Infectious Diseases, Sir Charles Gairdner Hospital, Queen Elizabeth II Medical Centre, Perth, Australia
1
School of Paediatrics and Child Health, University of Western Australia, Perth, Australia
10
2
Infectious Diseases Service, Department of General Paediatrics, Princess Margaret Hospital for Children, Perth, Australia
Division of Infectious Diseases, Department of Medicine, National University Hospital, Singapore, Singapore
11
3
PathWest Laboratory Medicine, Princess Margaret Hospital for Children, Perth, Australia
Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
12
4
Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Australia
Department of Microbiology and Infectious Diseases, Royal Perth Hospital, Perth, Australia
5
13
Department of Paediatrics, University of Otago, P.O. Box 4345, Christchurch Mail Centre, Christchurch 8140, New Zealand
School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Australia
6
Department of Infectious Diseases, Alfred Health, Melbourne, Victoria, Australia
14
Global and Tropical Health Division, Menzies School of Health Research, Darwin, Australia
7
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
15
Department of Immunology and Infectious Diseases, John Hunter Hospital, Newcastle, Australia
1590
previously reported the results of the survey, which were dominated by consultations in adult patients. This paper concentrates on the details of the paediatric consultations [2]. De-identified data were collected from individual patients seen by an ID physician using a web-based data entry system from hospitals in Australia and New Zealand. The hospitals included ten paediatric tertiary hospitals and regional general hospitals ranging in size from 300 paediatric beds. Demographics and clinical details were collected for patients seen who met the criteria for formal ID consultation or inpatient admission. As described previously [2], a formal ID consultation was defined as: (i) a consultation requested by another inpatient team or by local institutional rules and (ii) an ID registrar/fellow or physician examined the patient and made a medical record entry. An ID inpatient admission was defined as a patient being admitted under the care of an ID physician. Only the first episode of care was counted for any given patient. Infections were defined as either community onset (non-healthcare-associated and healthcare-associated) or nosocomial. Patients were excluded in the following situations: (i) telephone advice only, (ii) informal consultations where the patient was not seen, (iii) outpatient clinics, (iv) antibiotic stewardship activities and (v) other regular ID advisory rounds. Statistical analysis was performed by using SPSS 20.0.0 (IBM SPSS Statistics, IBM, Armonk, NY, USA). Differences in categorical variables were tested by the χ2 test or Fisher’s exact test. p-Values
ARTICLE
A comparison of paediatric and adult infectious diseases consultations in Australia and New Zealand C. C. Blyth 1,2,3,4 & T. Walls 5 & A. C. Cheng 6,7 & R. J. Murray 8,9 & D. A. Fisher 10,11 & P. R. Ingram 12,13 & J. S. Davis 14,15 & on behalf of the Australasian Society for Infectious Diseases Clinical Research Network and the Australian New Zealand Paediatric Infectious Diseases Research Network
Received: 3 March 2015 / Accepted: 15 April 2015 / Published online: 29 April 2015 # Springer-Verlag Berlin Heidelberg 2015
Abstract The objective of this paper is to describe paediatric infectious diseases consultations across Australia and New Zealand. We surveyed infectious diseases physicians at 51 hospitals over a period of 2 weeks in 2012. Compared with adult consults, paediatric consults were more frequently received from general paediatricians/physicians and intensive care, yet less frequently from surgeons and emergency. Respiratory, skin/soft tissue and bone/joint infections were the most frequent consultations in children. These data demonstrate the breadth of formal infectious diseases consults in children. Differences between paediatric and infectious diseases consultations need to be considered when planning both paediatric and adult physician training and future curriculum development.
* T. Walls [email protected]
Introduction Despite the increasing demand for advice offered by infectious diseases (ID) physicians, there are few data on the activities of ID physicians, particularly physicians consulting on children [1]. We describe the formal inpatient-related activities undertaken by ID physicians in Australia and New Zealand, focusing on paediatric ID consults.
Methods We conducted a prospective survey of ID physician-related activities over a fortnight in August (winter) 2012. We have
8
Department of Microbiology, PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Perth, Australia
9
Department of Infectious Diseases, Sir Charles Gairdner Hospital, Queen Elizabeth II Medical Centre, Perth, Australia
1
School of Paediatrics and Child Health, University of Western Australia, Perth, Australia
10
2
Infectious Diseases Service, Department of General Paediatrics, Princess Margaret Hospital for Children, Perth, Australia
Division of Infectious Diseases, Department of Medicine, National University Hospital, Singapore, Singapore
11
3
PathWest Laboratory Medicine, Princess Margaret Hospital for Children, Perth, Australia
Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
12
4
Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Australia
Department of Microbiology and Infectious Diseases, Royal Perth Hospital, Perth, Australia
5
13
Department of Paediatrics, University of Otago, P.O. Box 4345, Christchurch Mail Centre, Christchurch 8140, New Zealand
School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Australia
6
Department of Infectious Diseases, Alfred Health, Melbourne, Victoria, Australia
14
Global and Tropical Health Division, Menzies School of Health Research, Darwin, Australia
7
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
15
Department of Immunology and Infectious Diseases, John Hunter Hospital, Newcastle, Australia
1590
previously reported the results of the survey, which were dominated by consultations in adult patients. This paper concentrates on the details of the paediatric consultations [2]. De-identified data were collected from individual patients seen by an ID physician using a web-based data entry system from hospitals in Australia and New Zealand. The hospitals included ten paediatric tertiary hospitals and regional general hospitals ranging in size from 300 paediatric beds. Demographics and clinical details were collected for patients seen who met the criteria for formal ID consultation or inpatient admission. As described previously [2], a formal ID consultation was defined as: (i) a consultation requested by another inpatient team or by local institutional rules and (ii) an ID registrar/fellow or physician examined the patient and made a medical record entry. An ID inpatient admission was defined as a patient being admitted under the care of an ID physician. Only the first episode of care was counted for any given patient. Infections were defined as either community onset (non-healthcare-associated and healthcare-associated) or nosocomial. Patients were excluded in the following situations: (i) telephone advice only, (ii) informal consultations where the patient was not seen, (iii) outpatient clinics, (iv) antibiotic stewardship activities and (v) other regular ID advisory rounds. Statistical analysis was performed by using SPSS 20.0.0 (IBM SPSS Statistics, IBM, Armonk, NY, USA). Differences in categorical variables were tested by the χ2 test or Fisher’s exact test. p-Values
