2009 DOM Annual Report - Department of Medicine - University of ...

2007The goals of the Division of Infectious Diseases (ID) are to providestate-of-the-art care to patients with infectious diseases that is easilyaccessible to patients and responsive to the needs of our physiciancolleagues; to mentor fellows in our training program to become thenext generation of academic ID specialists; to rigorously train medicalstudents and residents in the discipline of ID; to perform “cuttingedge”laboratory and clinical research and translate progress thatarises into clinical practice; and to develop and implement policies toprotect the public health from natural and man-made epidemics.Research awards for fiscal year 2007 totaled $6,187,695 in total costsfrom the NIH, Centers for Disease Control and Prevention (CDC),Health Resources and Services Administration (HRSA), the Departmentof Veterans Administration and Industry. The HIV/AIDS Programsuccessfully competed again for Ryan White HRSA funding for a periodof five years. In fiscal year 2008, five to six new research faculty, withexpertise in transplant ID, mycology, and HIV-1 pathogenesis, willrelocate to the ID Division. This will strengthen the research portfolioof the Division and support the patient care needs in ID at UPMC.CLINICALThe inpatient ID Consult Services continued to be a major clinical focusof the Division. In addition to the regular rounding teams, two newID Consult Services were established in the past few years to meet thegrowing needs of UPMC Health System. The Surgical ID Service, whichconsults on patients with neurosurgical, cardiothoracic, orthopaedic orear, nose and throat infections was added to the Clostridium difficile(C.difficile) Management Service, which initially played a significantrole in educating physicians about this particular disease, and now hasan “on demand” order set so that the appropriate treatment can begiven to patients in order to avoid negative outcomes.The number of inpatient consults increased by 26% between fiscalyear 2006 and fiscal year 2007, and there was a 22% increase infollow-up visits within the same time period. This increase is a resultof several factors: 1) expansion of the Surgical ID Service; 2) increasedactivity on the Transplant ID Service related to the rising number ofsolid organ transplants; and 3) increased coverage at Magee-WomensHospital. Similarly, total outpatient visits had an increase of 9%over the prior year. Outpatients requiring ID consults and followupvisits were evaluated in the General ID Clinic, which has grownfrom one morning clinic per week to four half day clinics every week.Additionally, the UPMC HIV/AIDS program provided primary care toapproximately 1,200 HIV infected persons from the tri-state area, and148 new patients entered into care.TEACHINGThe Division continues to be active in education by teaching medicalstudents, pre-doctoral students at the Graduate School of PublicHealth, and residents. Our activity in the medical school includes afirst year course that introduces the basic science of infectious disease,second year courses about the organ systems, an opportunity in thethird year to experience the HIV/AIDS Ambulatory Clinic, and, finally,the chance to rotate on the inpatient infectious disease consultservice in the third or fourth year, during which time the medicalstudents are assigned patients. The bulk of residency and housestaffteaching occurred on the General ID Consult Services and at theHIV/AIDS outpatient clinic. This ward teaching was complementedby weekly Resident and Medical Student Core Curriculum lectures, aweekly clinical conference, a weekly journal club, a weekly HIV clinicalconference and a biweekly joint research seminar with the MolecularVirology and Microbiology Program.The Infectious Diseases Fellowship Training program providesexcellent clinical training and provides opportunities for fellows toconduct research with nationally-known investigators. Advanced“Research awards for Fiscal Year 2007 totaled$6,187,695 in total costs from the NIH, Centersfor Disease Control and Prevention (CDC), HealthResources and Services Administration (HRSA),the Department of Veterans Administration, andindustry. ”RESEARCHA major activity of the ID Division is laboratory and clinical research.These activities are grouped into specific Research Units led bya senior investigator. Research Units within the Division includeEpidemiology, Infection Control, Antibiotic Management, SpecialPathogens, Geriatric Infectious Diseases, HIV/AIDS, Viral Diseases, SolidOrgan Transplant Infectious Diseases and Surgical Infectious Diseases/Biosecurity.training in infectious diseases research is available through ourNIH-funded NRSA Training Grant. Recent and current fellows havetrained at the University of Pittsburgh, Boston University, AlbertEinstein College of Medicine and other excellent institutions. Ourfellows’ accomplishments are promoted by faculty mentors and mostrecently one fellow was awarded the highly-competitive IDSA/NFIDPfizer Global Fellowship in Infectious Diseases for his research onantimicrobial resistance among gram-negative bacteria. Trainingin infectious diseases is intense and high-volume and provides the41