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Infectious diseases consultations from general internal medicine physicians in Japan: A descriptive single-center
Yoshiro Hadano1,2, Shintaro Kosaka3, Yoshitaka Tomoda3,4
1Antimicrobial Stewardship Team, Itabashi Chuo Medical Center, Itabashi-ku, Japan.
Abstract:
In Japan, general internal medicine (GIM) physicians must be aware of frequently encountered infections because of the shortage of infectious disease (ID) specialists. However, there are currently no epidemiological data on this subject. This study aimed to describe the frequency and pattern of ID consultations requested by GIM physicians in Japan. This is a 3-year retrospective review of the ID consultations requested by GIM physicians in Japan at a community-based acute tertiary care teaching hospital in Tokyo from April 2018 to March 2021. Demographic data, such as reasons for consultation, causative organism, and final diagnoses, were collected. During the study period, ID consultations were requested by GIM physicians 128 times. The incidence rates of bacteremia and 30-day mortality were 65.6% (n = 84) and 3.1% (n = 4), respectively. The most common diagnostic classifications after ID consultation were bone/joint (24.2%, n = 31), respiratory (17.7%, n = 22), and cardiovascular infections (12.5%, n = 16). The most common final diagnoses were bacteremia (11.7%, n = 15), infective endocarditis (9.4%, n = 12), and vertebral osteomyelitis (7.8%, n = 10). This is the first study to describe the ID consultation cases requested by GIM physicians in Japan in a community-based acute tertiary care teaching hospital. Despite the shortage of ID specialists, GIM physicians covered a wide range of IDs, including bone/joint infections and infectious endocarditis, which require long-term care. ID and GIM physicians, including hospitalists, should cooperate to promote the quality of care and clinical management. Future multi-center studies with large numbers of clinical cases are needed to determine the ID clinical knowledge required by GIM physicians in Japan.
Insights
General internal medicine physicians in Japan frequently consult on infections like bacteremia and bone/joint infections due to a shortage of infectious disease specialists. This study highlights their broad case management capabilities.
Area of Science:
- Infectious Diseases
- Internal Medicine
- Epidemiology
Background:
- General internal medicine (GIM) physicians in Japan face a shortage of infectious disease (ID) specialists.
- There is a lack of epidemiological data on infections managed by GIM physicians in Japan.
- GIM physicians need to be aware of frequently encountered infections.
Purpose of the Study:
- To describe the frequency and pattern of infectious disease consultations requested by GIM physicians in Japan.
- To provide epidemiological data on ID consultations in a Japanese community-based hospital.
- To understand the scope of infectious disease management by GIM physicians.
Main Methods:
- A 3-year retrospective review of ID consultations requested by GIM physicians.
- Data collected included reasons for consultation, causative organisms, and final diagnoses.
- The study was conducted at a community-based acute tertiary care teaching hospital in Tokyo (April 2018 - March 2021).
Main Results:
- 128 ID consultations were requested by GIM physicians over the study period.
- Common diagnostic classifications included bone/joint (24.2%), respiratory (17.7%), and cardiovascular infections (12.5%).
- The most frequent final diagnoses were bacteremia (11.7%), infective endocarditis (9.4%), and vertebral osteomyelitis (7.8%). Bacteremia incidence was 65.6% with a 30-day mortality of 3.1%.
Conclusions:
- GIM physicians in Japan manage a wide spectrum of infectious diseases, including complex cases like infective endocarditis and osteomyelitis.
- Despite the ID specialist shortage, GIM physicians demonstrate capability in managing diverse infections.
- Collaboration between ID and GIM physicians is recommended to enhance patient care quality and clinical management.
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