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Infectious Diseases | Counties Manukau

Public Service, Infectious Diseases

Description

Infectious Diseases is the branch of medicine which deals with the diagnosis and management of diseases which involve infection of the human body. These may involve bacteria, viruses, fungi and parasites. These infections may occur in the community or as a complication of treatment in hospital. Many of these conditions are dealt with by other medical and surgical teams but some require a specialist approach.
 

The Infectious Diseases team is made up of specialists in infectious diseases and registrars training in the discipline. The team liaises closely with the clinical microbiologists in the laboratory as well as specialist pharmacists, nurses and infection control personnel.

Click on links for information on our bio-containment unit.

For information on Ebola please visit the Counties Manukau Health or  Ministry of Health websites.

Infectious Disease Services Provided by Counties Manukau Health
Inpatient services are provided at Middlemore Hospital and outpatient clinics are held at Manukau SuperClinic™.

Consultants

Referral Expectations

Acute Patients Middlemore Hospital 
If you are acutely unwell, your GP may refer you to the Acute Assessment and Admitting Service in the Emergency Department at the front of Middlemore Hospital. The Medical team working in the Emergency Care Department will look after you, and if your condition is considered to be an infection, advice may be requested from the Infectious Diseases specialty. You may be admitted to hospital for investigation and treatment.

Outpatients
If the referral is less urgent and the referring doctor is requesting help in the management of your condition, the doctor will request an appointment in the Infectious Diseases outpatient clinic.  Waiting times for the appointment depend on the urgency of the condition as outlined in the information supplied by your doctor, but vary between 2 weeks and 1-2 months.

In the outpatient clinic you will be seen by a member of the medical specialist team who will ask questions about your illness, examine you and possibly order further investigations. This may involve having, for example, x-rays or blood tests and then returning to clinic when all the results have been received.  Once a diagnosis is made, management of your condition will be outlined to you and you will either be requested to return to the clinic or to see your GP for follow-up.
 
Infectious Diseases outpatient clinics are held on:
  • Thursday mornings 

Not all referrals are seen in a face-to-face consultation; instead your doctor may receive advice on how to manage your condition or investigate it further.

Fees and Charges Description

There are no charges for services to public patients if you are lawfully in New Zealand and meet one of the Eligibility Directions specified criteria set by the Ministry of Health.  If you do not meet the criteria, you will be required to pay for the full costs of any medical treatment you receive during your stay.

To check whether you meet the specified eligibility criteria, visit the Ministry of Health website www.moh.govt.nz/eligibility

For any applicable charges, please phone the Accounts Receivable Office on (09) 2760060.

Services

Prosthetic Joint Infections

The following set of guidelines represent a collaborative consensus from the orthopaedic, infectious diseases, microbiology, infection control and pharmacy departments at Counties Manukau Health (CMH) for the management of adult patients with suspected Periprosthetic Joint Infections (PJIs). They are not intended for paediatric patients (please liaise with the relevant department for advice) and contain CMH specific advice. The guidelines are “living documents” and are therefore subject to ongoing revision. Guidelines should be regularly consulted for the most recent available advice. Feedback on guidelines is welcome. Please direct any feedback to (infectious diseases physician) or (orthopaedic surgeon). Acute Periprosthetic Joint Infections Guideline (PDF, 195.9 KB) This guideline has been created by the Counties Manukau Periprosthetic Joint Infection Working group and covers the acute management of suspected periprosthetic joint infection (PJI). Surgical Strategies in the Management of Periprosthetic Joint Infections Guideline (PDF, 331 KB) This document has been developed by the Counties Manukau periprosthetic joint infection working group which includes representation from the orthopaedic, infectious diseases, microbiology and infection control departments at Middlemore Hospital. The aim is to provide a framework for surgical decision making to ensure a degree of consistency based on available literature, including the IDSA and Philadelphia consensus guidelines on the management of prosthetic joint infections. The authors acknowledge the complicated nature of this decision and that it is NOT possible to encompass all situations in a guidance document. The authors also acknowledge that decisions will need to be adjusted depending on future events subsequent to the initial surgical strategy decision. Periprosthetic Joint Infection Sampling Guideline (PDF, 823 KB) This guideline aims to provide guidance on standard of care microbiological sampling for suspected prosthetic joint infections. Periprosthetic Joint Sample Form (Lab Form) (PDF, 41.5 KB) This is the laboratory request form that must accompany the culture specimens taken during surgery. Periprosthetic Joint Infection Communication Form (PDF, 200.7 KB) This guideline is designed to facilitate communication between the services regarding the patient specific management strategy Elective Arthroplasty Urinary Screening Procedure (PDF, 100.7 KB) The purpose of this procedure is to identify the necessary steps to take after elective urinary screening.The utility of routine preoperative urinary screening for all patients undergoing elective arthroplasty surgery has been reviewed and is no longer recommended. The new protocol for urinary screening is detailed within.

The following set of guidelines represent a collaborative consensus from the orthopaedic, infectious diseases, microbiology, infection control and pharmacy departments at Counties Manukau Health (CMH) for the management of adult patients with suspected Periprosthetic Joint Infections (PJIs).

They are not intended for paediatric patients (please liaise with the relevant department for advice) and contain CMH specific advice.

The guidelines are “living documents” and are therefore subject to ongoing revision. Guidelines should be regularly consulted for the most recent available advice.

Feedback on guidelines is welcome. Please direct any feedback to (infectious diseases physician) or (orthopaedic surgeon).

  • Acute Periprosthetic Joint Infections Guideline (PDF, 195.9 KB)

    This guideline has been created by the Counties Manukau Periprosthetic Joint Infection Working group and covers the acute management of suspected periprosthetic joint infection (PJI).

  • Surgical Strategies in the Management of Periprosthetic Joint Infections Guideline (PDF, 331 KB)

    This document has been developed by the Counties Manukau periprosthetic joint infection working group which includes representation from the orthopaedic, infectious diseases, microbiology and infection control departments at Middlemore Hospital. The aim is to provide a framework for surgical decision making to ensure a degree of consistency based on available literature, including the IDSA and Philadelphia consensus guidelines on the management of prosthetic joint infections. The authors acknowledge the complicated nature of this decision and that it is NOT possible to encompass all situations in a guidance document. The authors also acknowledge that decisions will need to be adjusted depending on future events subsequent to the initial surgical strategy decision.

  • Periprosthetic Joint Infection Sampling Guideline (PDF, 823 KB)

    This guideline aims to provide guidance on standard of care microbiological sampling for suspected prosthetic joint infections.

  • Periprosthetic Joint Sample Form (Lab Form) (PDF, 41.5 KB)

    This is the laboratory request form that must accompany the culture specimens taken during surgery.

  • Periprosthetic Joint Infection Communication Form (PDF, 200.7 KB)

    This guideline is designed to facilitate communication between the services regarding the patient specific management strategy

  • Elective Arthroplasty Urinary Screening Procedure (PDF, 100.7 KB)

    The purpose of this procedure is to identify the necessary steps to take after elective urinary screening.The utility of routine preoperative urinary screening for all patients undergoing elective arthroplasty surgery has been reviewed and is no longer recommended. The new protocol for urinary screening is detailed within.

Spinal Infections

This guideline addresses the management of adult patients (≥15 years old) presenting to CMDHB with suspected native vertebral osteomyelitis/discitis (NVO). For the purposes of this guideline NVO will relate to vertebral osteomyelitis and/or vertebral discitis. The advice contained is felt to be appropriate for the vast majority of patients presenting with suspected NVO however it does not replace clinical judgement. This guideline is NOT applicable to the following populations… Post-operative or metal ware associated spinal infections. Spinal infections with a contiguous source (e.g. pressure sore associated spinal infections, post-traumatic spinal infections). Paediatric patients (<15 years old) Native Vertebral Osteomyelitis/Discitis Guideline (PDF, 218.4 KB)

This guideline addresses the management of adult patients (≥15 years old) presenting to CMDHB with suspected native vertebral osteomyelitis/discitis (NVO). For the purposes of this guideline NVO will relate to vertebral osteomyelitis and/or vertebral discitis. The advice contained is felt to be appropriate for the vast majority of patients presenting with suspected NVO however it does not replace clinical judgement.

This guideline is NOT applicable to the following populations…

  1. Post-operative or metal ware associated spinal infections.
  2. Spinal infections with a contiguous source (e.g. pressure sore associated spinal infections, post-traumatic spinal infections).
  3. Paediatric patients (<15 years old)

Contact Details

This page was last updated at 2:34PM on December 19, 2022. This information is reviewed and edited by Infectious Diseases | Counties Manukau.