Journal Article

Infectious Disease Consultation and Microbiologic Surveillance for Intensive Care Unit Trauma Patients: A Pilot Study

Barry C. Fox, Peter B. Imrey, Mary Beth Voights and Scott Norwood

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 33, issue 12, pages 1981-1989
Published in print December 2001 | ISSN: 1058-4838
Published online December 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/324083
Infectious Disease Consultation and Microbiologic Surveillance for Intensive Care Unit Trauma Patients: A Pilot Study

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  • Infectious Diseases
  • Immunology
  • Public Health and Epidemiology
  • Microbiology

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Infection remains a major cause of posttrauma morbidity. We retrospectively reviewed 2 cohorts of trauma patients admitted to a regional trauma center before and after a policy change integrating prospective microbiologic surveillance and infectious disease (ID) consultation into management of trauma admissions. Primary interests were effects of this policy change on antimicrobial use and diagnostic precision (particularly differentiation of infection from colonization). Associated costs, microflora, survival, and disability were also compared. Patients were stratified for risk of infection. ID consultation was associated with a 49% increased odds that an infection diagnosis was microbiologically based (P = .006) and 57% reduction of antibiotics costs per hospitalized day (P = .0008). Costs of consultation and an 86% increase (P < 10-6) in total cultures combined to minimally exceed that financial saving. The observed improvements in diagnostic precision and antimicrobial usage, however, suggest consideration of prospective microbiologic surveillance and multidisciplinary physician teams including ID physicians for high-risk trauma patients.

Journal Article.  5308 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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