Staffing for infectious diseases, clinical microbiology and infection control in hospitals in 2015: results of an ESCMID-member survey

OBJECTIVES: We aimed to assess the current status of infectious diseases (ID), clinical microbiology (CM) and infection control (IC) staffing in hospitals and to analyze modifiers of staffing levels.

METHODS: 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/100 hospital beds. Regression analyses were conducted to examine factors associated with the physician/bed ratio.

RESULTS: 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 88-90% for local antibiotic guidelines and 70-82% for programmes monitoring hospital-acquired infections. The median ID/CM/IC physician/100 hospital-bed ratio was 1.12 (IQR 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 (IQR 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 infection control or management.

CONCLUSIONS: 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.