Surveillance of nosocomial infections in ICUs: is postdischarge surveillance indispensable?
OBJECTIVE
To determine how many infections are missed if the postdischarge surveillance (PDS) follow-up of intensive care unit (ICU) patients that is required by the National Nosocomial Infection Surveillance System method is not done.


METHODS
ICU patients were followed up and surveillance results with PDS (gold standard) and without PDS were compared.


METHODS
Surgical or interdisciplinary ICUs in eight German acute-care hospitals.


METHODS
All 1,857 patients within a 6-month period in the participating ICUs (a total of 9,129 ICU-patient-days).


RESULTS
Without PDS, 45 urinary tract infections (UTIs) were diagnosed, compared with 53 with PDS; thus, 15% of the UTIs were missed if no postdischarge follow-up was performed. Three nosocomial pneumonias (4%) and one bloodstream infection (8%) also were missed if surveillance was carried out without PDS. A total of 198 nosocomial infections (NIs) were recorded with PDS, compared to 175 NIs without PDS. Approximately 12% of all ICU-associated NIs were missed if no follow-up was done.


CONCLUSIONS
Since it is very time-consuming to follow patients after their transfer from the ICU, we do not perform a postdischarge follow-up of patients in the course of routine surveillance.
Geffers
C
C
Institute for Hygiene, Free University of Berlin, Germany.
Gastmeier
P
P
Bräuer
H
H
Daschner
F
F
Rüden
H
H
D003428:Cross Infection / Q000453:epidemiology*; D004812:Epidemiologic Methods; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007362:Intensive Care Units; D010351:Patient Discharge; D011159:Population Surveillance / Q000379:methods*; D011795:Surveys and Questionnaires; D013997:Time Factors