title: Staffing for infectious diseases, clinical microbiology and infection control in hospitals in 2015: results of an ESCMID member survey.
abstract: We aimed to assess the current status of infectious diseases (ID), clinical microbiology (CM) and infection control (IC) staffing in hospitals and to analyse modifiers of staffing levels. We conducted an Internet-based survey of European Society of Clinical Microbiology and Infectious Diseases members and affiliates, collecting data on hospital characteristics, ID management infrastructure, ID/IC-related activities and the ratio of physicians per 100 hospital beds. Regression analyses were conducted to examine factors associated with the physician-bed ratio. Five hundred sixty-seven hospital responses were collected between April and June 2015 from 61 countries, 81.2% (384/473) from Europe. A specialized inpatient ward for ID patients was reported in 58.4% (317/543) of hospitals. Rates of antibiotic stewardship programmes (ASP) and surveillance activities in survey hospitals were high, ranging from 88% to 90% for local antibiotic guidelines and 70% to 82% for programmes monitoring hospital-acquired infections. The median ID/CM/IC physician per 100 hospital beds ratio was 1.12 (interquartile range 0.56-2.13). In hospitals performing basic ASP and IC (including local antibiotic guidelines and monitoring device-related or surgical site infections), the ratio was 1.21 (interquartile range 0.57-2.14). Factors independently associated with higher ratios included compliance with European Union of Medical Specialists standards, smaller hospital size, tertiary-care institution, presence of a travel clinic, beds dedicated to ID and a CM unit. More than half of respondents estimated that additional staffing is needed for appropriate IC or ID management. No standard of physician staffing for ID/CM/IC in hospitals is available. A ratio of 1.21/100 beds will serve as an informed point of reference enabling ASP and infection surveillance.
authors.affiliation: Division of Infectious Diseases, Rambam Health Care Campus, Haifa, Israel.
authors.forename: Y
authors.initials: Y
authors.lastname: Dickstein
authors.affiliation: Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Centre, Jerusalem, Israel.
authors.forename: R
authors.initials: R
authors.lastname: Nir-Paz
authors.affiliation: Université de Lorraine, Université Paris Descartes, EA 4360 APEMAC and CHU de Nancy, Service de Maladies Infectieuses et Tropicales, Nancy, France.
authors.forename: C
authors.initials: C
authors.lastname: Pulcini
authors.affiliation: Division of Infection and Immunity, University College London, Gower Street, London, United Kingdom.
authors.forename: B
authors.initials: B
authors.lastname: Cookson
authors.affiliation: Department of Infectious Diseases, University Medical Centre, Ljubljana, Slovenia.
authors.forename: B
authors.initials: B
authors.lastname: Beović
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine I, DZIF Center, Tübingen University Hospital, Tübingen, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Tacconelli
authors.affiliation: Ninewells Hospital and Medical School, Dundee DD1 9SY, United Kingdom.
authors.forename: D
authors.initials: D
authors.lastname: Nathwani
authors.affiliation: Department of Microbiology and Virology, University Hospital Queen Joanna, Sofia, Bulgaria.
authors.forename: R
authors.initials: R
authors.lastname: Vatcheva-Dobrevska
authors.affiliation: Unidad Clínica Intercentros de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospitales Universitarios Virgen Macarena y Virgen del Rocío, Seville, Spain; Departamento de Medicina, Universidad de Sevilla, Seville, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Rodríguez-Baño
authors.affiliation: Department of Hospital Epidemiology and Infection Control, University Hospital, Paracelsus Medical University, Salzburg, Austria.
authors.forename: M
authors.initials: M
authors.lastname: Hell
authors.affiliation: European Society of Clinical Microbiology and Infectious Diseases (ESCMID), Basel, Switzerland.
authors.forename: H
authors.initials: H
authors.lastname: Saenz
authors.affiliation: Medicine E, Rabin Medical Centre, Beilinson Hospital, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: L
authors.initials: L
authors.lastname: Leibovici
authors.affiliation: Division of Infectious Diseases, Rambam Health Care Campus, Haifa, Israel; The Ruth and Bruce Rappaport Faculty of Medicine-Technion, Israel Institute of Technology, Haifa, Israel. Electronic address: paulm@post.tau.ac.il.
authors.forename: M
authors.initials: M
authors.lastname: Paul
mesh_terms: D003140:Communicable Disease Control; D003141:Communicable Diseases / Q000453:epidemiology*; D005060:Europe / Q000453:epidemiology; D005260:Female; D005843:Geography; D006282:Health Personnel; D006761:Hospitals; D006801:Humans; D017053:Infection Control / Q000458:organization & administration*; D020407:Internet; D008297:Male; D008829:Microbiology / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D000078329:Workforce
keywords: Clinical microbiology; ESCMID; Infection control; Infectious disease; Staffing