title: Burden and spectrum of infectious disease in Germany 2009-2014: a multicentre study from Berlin's Municipal Hospitals.
abstract: OBJECTIVE
  This study aimed at assessing the burden and spectrum of infectious diseases (ID) in a Metropolitan population in Germany.
  
  
  METHODS
  A discharge database using ICD-10 codes enabled the identification of hospitalizations with infection-related diagnoses. All hospital admissions between 2009 and 2014 were analysed from 9 municipal hospitals serving approximately one-third of an urban population of 3.5 million people.
  
  
  RESULTS
  We identified 114,168 admissions with a primary (first-listed) ID diagnosis and 220,483 admissions with any-listed ID diagnosis, accounting for 8.9 % [95 % confidence interval (CI) 8.9-9.0 %] and 17.2 % (95 % CI 17.1-17.3) of all 1,284,559 admissions, respectively. Annually, 439,837 bed-days (range 413,707-488,520) were occupied by patients with an ID diagnosis, utilizing 22.8 % of total bed capacity. The median length of stay for patients with primary ID diagnosis and secondary ID diagnosis was 6 days (IQR 3-11) and 10 days (IQR 5-19), respectively. The most common diagnosis across all age groups was "pneumonia" (22.8 and 16.2 % of ID admissions as primary and secondary diagnosis, respectively). In-hospital mortality was 6.8 % (95 % CI 6.6-6.9) and 8.9 % (95 % CI 8.7-9.1) for ID as primary and secondary diagnosis, respectively.
  
  
  CONCLUSIONS
  Infectious diseases contribute significantly to the overall burden of disease in a health system caring for an urban German population. In view of the magnitude of ID's contribution, establishing more specialists in ID medicine and adjusting the reimbursements for managing infection-related admissions should be made a public health priority in Germany.
authors: Department of Infectious Diseases, Vivantes Auguste-Viktoria-Klinikum, Rubensstraße 125, 12157, Berlin, Germany. juri.katchanov@icloud.com.
authors: Juri
authors: J
authors: Katchanov
authors: Department of Infectious Diseases, Vivantes Auguste-Viktoria-Klinikum, Rubensstraße 125, 12157, Berlin, Germany.
authors: Kai
authors: K
authors: Wöstmann
authors: Department of Infectious Diseases, Vivantes Auguste-Viktoria-Klinikum, Rubensstraße 125, 12157, Berlin, Germany.
authors: Daniela
authors: D
authors: Tominski
authors: Department of Infectious Diseases, Vivantes Auguste-Viktoria-Klinikum, Rubensstraße 125, 12157, Berlin, Germany.
authors: Laura
authors: L
authors: Jefferys
authors: Department of Infectious Diseases, Vivantes Auguste-Viktoria-Klinikum, Rubensstraße 125, 12157, Berlin, Germany.
authors: Anna
authors: A
authors: Liedtke
authors: Department of Infectious Diseases, Vivantes Auguste-Viktoria-Klinikum, Rubensstraße 125, 12157, Berlin, Germany.
authors: Arnim
authors: A
authors: Schneider
authors: Septomics Research Center, Jena University Hospital, Jena, Germany.
authors: Hortense
authors: H
authors: Slevogt
authors: Department of Infectious Diseases, Vivantes Auguste-Viktoria-Klinikum, Rubensstraße 125, 12157, Berlin, Germany.
authors: Keikawus
authors: K
authors: Arastéh
authors: Department of Infectious Diseases, Vivantes Auguste-Viktoria-Klinikum, Rubensstraße 125, 12157, Berlin, Germany.
authors: Hartmut
authors: H
authors: Stocker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001604:Berlin / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003141:Communicable Diseases / Q000453:epidemiology*; D005260:Female; D006296:Health Services; D006298:Health Services Administration; D006773:Hospitals, Municipal; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D014505:Urban Population; D055815:Young Adult
keywords: Burden of disease; ID services; ID subspecialty; Infection