Impact of infectious diseases service consultation on diagnosis of infective endocarditis

Shungo Yamamoto, Naoto Hosokawa, Misa Sogi, Mai Inakaku, Kazuya Imoto, Goh Ohji, Asako Doi, Sentaro Iwabuchi, Kentaro Iwata

Research output: Contribution to journalArticlepeer-review

19 Citations (Scopus)

Abstract

Background: The infectious diseases (ID) consultation service is a new clinical entity in Japan. We examined the impact of ID consultation on the diagnosis of infective endocarditis (IE) at a large teaching hospital in Japan. Methods: Routine consultation with an ID service for cases of positive blood culture was implemented at Kameda Medical Center in November 2004. In addition, ID service doctors started to give lectures on ID to doctors and also provided local guidelines on ID. We compared the incidence of IE during a 3-y and 10-month period before intervention with that during a 5-y and 2-month period after intervention. The modified Duke criteria were used to confirm the diagnosis of definite IE. Patients who fulfilled the criteria for definite IE were included in the analysis. Results: Twenty-seven cases of IE were diagnosed before the implementation of routine consultation, and 76 cases after. The respective incidences of IE were 48.7 and 84.8 per 100,000 patients discharged from the hospital (p = 0.01). The relapse rate of IE within 6 months was significantly lower in patients who underwent routine consultation (22.2% vs 2.2%; p = 0.02). Conclusion: Routine consultation with an ID service for cases of positive blood culture, together with consecutive lecturing and local guidelines by ID specialists, resulted in improved detection of IE and a reduced relapse rate within 6 months. Timely consultation with an ID specialist in bacteraemia cases may be beneficial for improving the outcomes of patients in this setting.

Original languageEnglish
Pages (from-to)270-275
Number of pages6
JournalScandinavian Journal of Infectious Diseases
Volume44
Issue number4
DOIs
Publication statusPublished - 2012 Apr

Keywords

  • Infective endocarditis
  • bacteraemia
  • blood culture
  • infectious diseases consultation

ASJC Scopus subject areas

  • Immunology and Microbiology(all)
  • Microbiology (medical)
  • Infectious Diseases

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