{"id":8655,"date":"2018-03-18T18:27:09","date_gmt":"2018-03-18T22:27:09","guid":{"rendered":"https:\/\/blogs.nejm.org\/hiv-id-observations\/?p=8655"},"modified":"2018-03-19T14:59:50","modified_gmt":"2018-03-19T18:59:50","slug":"why-with-extremely-resistant-infections-its-extremely-important-to-consult-id","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/why-with-extremely-resistant-infections-its-extremely-important-to-consult-id\/2018\/03\/18\/","title":{"rendered":"Why with Extremely Resistant Infections, It&#8217;s Extremely Important to Consult ID"},"content":{"rendered":"<p><a href=\"https:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2018\/03\/s_cover.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignright size-full wp-image-8658\" src=\"https:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2018\/03\/s_cover.png\" alt=\"\" width=\"137\" height=\"180\" \/><\/a>Since the only procedures most of us Infectious Diseases  doctors do with any regularity are biopsies of patient medical records, we have to justify our existence in other ways &#8212; such as collecting data on how our expertise improves patient outcomes.<\/p>\n<p>There are a bunch of these papers published, with <a href=\"https:\/\/academic.oup.com\/cid\/article\/58\/1\/22\/372657\" target=\"_blank\" rel=\"noopener\">this one<\/a> being the most widely cited (the title says it all):<\/p>\n<p style=\"padding-left: 30px\"><strong><em>Infectious Diseases Specialty Intervention Is Associated With Decreased Mortality and Lower Healthcare Costs\u00a0\u00a0<\/em><\/strong><\/p>\n<p>Here are a few more, hardly a comprehensive list:<\/p>\n<ul>\n<li><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/25701854\" target=\"_blank\" rel=\"noopener\"><em><strong>Staph aureus<\/strong><\/em><strong> bacteremia<\/strong><\/a>\u00a0(one of <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/26453841\" target=\"_blank\" rel=\"noopener\">several<\/a>) &#8212; some hospitals mandate ID consultation for this entity<\/li>\n<li><strong><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/25009289\" target=\"_blank\" rel=\"noopener\">Infections related to solid organ transplantation<\/a><\/strong><\/li>\n<li><strong><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/27927865\" target=\"_blank\" rel=\"noopener\">Cryptococcal infection<\/a>\u00a0<\/strong>&#8212; as I&#8217;ve written before, who would try managing this tricky condition without ID input?<\/li>\n<li><strong><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/22176644\" target=\"_blank\" rel=\"noopener\">Endocarditis<\/a><\/strong><\/li>\n<li><strong><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/16941324\" target=\"_blank\" rel=\"noopener\">Candidemia<\/a><\/strong><\/li>\n<\/ul>\n<p>Now, a paper <a href=\"https:\/\/academic.oup.com\/ofid\/article\/5\/3\/ofy026\/4925511\" target=\"_blank\" rel=\"noopener\">just published in <\/a><em>Open Forum Infectious Diseases\u00a0<\/em>looks at the effect of ID consultation on outcomes in patients hospitalized with multidrug-resistant organisms (MDROs).<\/p>\n<p>The retrospective review spanned nearly 10 years of data and\u00a0included over 4000 patients. The researchers found that ID consultation was associated with a significant reduction in\u00a0all-cause mortality for drug-resistant\u00a0<em>S. aureus<\/em>,\u00a0Enterobacteriaceae, and polymicrobial MDRO infections.<\/p>\n<p>For some of these infections, the effect was huge &#8212; a 50% decrease in deaths. Patients with resistant gram-negative infections also had a reduction in 30-day readmissions.<\/p>\n<p>Studies like this are critically important to our specialty. They demonstrate the value of Infectious Diseases in ways that go far beyond simply counting &#8220;relative value units&#8221; (RVUs), a scoring system where we invariably come up short.<\/p>\n<p>Finally, leave it to\u00a0that bastion of common sense, <em>Consumer Reports<\/em>, to <a href=\"https:\/\/www.consumerreports.org\/medical-conditions\/the-one-doctor-you-need-to-see-if-you-get-an-antibiotic-resistant-infection\/\" target=\"_blank\" rel=\"noopener\">summarize the results perfectly<\/a>:<\/p>\n<p><a href=\"https:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2018\/03\/If_You_Have_an_Antibiotic-Resistant_Infection_-_Consumer_Reports.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-8659\" src=\"https:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2018\/03\/If_You_Have_an_Antibiotic-Resistant_Infection_-_Consumer_Reports-1024x261.jpg\" alt=\"\" width=\"459\" height=\"117\" srcset=\"https:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2018\/03\/If_You_Have_an_Antibiotic-Resistant_Infection_-_Consumer_Reports-1024x261.jpg 1024w, https:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2018\/03\/If_You_Have_an_Antibiotic-Resistant_Infection_-_Consumer_Reports-300x76.jpg 300w, https:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2018\/03\/If_You_Have_an_Antibiotic-Resistant_Infection_-_Consumer_Reports-768x196.jpg 768w, https:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2018\/03\/If_You_Have_an_Antibiotic-Resistant_Infection_-_Consumer_Reports.jpg 1092w\" sizes=\"auto, (max-width: 459px) 100vw, 459px\" \/><\/a><\/p>\n<p>Aside from the hyphen between &#8220;infectious-disease&#8221; in the subtitle, I couldn&#8217;t have said it better myself!<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Since the only procedures most of us Infectious Diseases doctors do with any regularity are biopsies of patient medical records, we have to justify our existence in other ways &#8212; such as collecting data on how our expertise improves patient outcomes. There are a bunch of these papers published, with this one being the most [&hellip;]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,5,8,10],"tags":[498],"class_list":["post-8655","post","type-post","status-publish","format-standard","hentry","category-health-care","category-infectious-diseases","category-patient-care","category-research","tag-infectious-diseases"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/8655","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/comments?post=8655"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/8655\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/media?parent=8655"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/categories?post=8655"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/tags?post=8655"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}