title: Intensive care unit-acquired infections: is postdischarge surveillance useful?
abstract: OBJECTIVE
  To assess the added value of surveying patients after discharge from the intensive care unit.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Medical intensive care unit of a large teaching hospital.
  
  
  METHODS
  All patients admitted to the intensive care unit for 48 hrs or more from October 1995 to November 1997.
  
  
  RESULTS
  We prospectively surveyed 1,068 patients during their intensive care unit stay and for 5 days after intensive care unit discharge. We detected 554 intensive care unit-acquired infections, yielding an infection rate of 70.7 per 1,000 patient days. Of these, only 31 infections (5.6%) in 27 patients were detected after intensive care unit discharge. If postdischarge surveillance was targeted on patients who had had a central vascular catheter while in the intensive care unit, only one infected patient would have been missed, but only 554 out of 889 would have been followed up (sensitivity, 96.2%; specificity, 38.7%; negative predictive value, 99.7%).
  
  
  CONCLUSIONS
  Surveillance of all patients discharged from the medical intensive care unit is not recommended, as it is resource demanding and allows the detection of few additional infections. However, targeted postdischarge surveillance could be a rational alternative, and selection criteria need to be refined and validated.
authors.affiliation: Infection Control Program, Department of Internal Medicine, University of Geneva Hospitals, 1211 Geneva 14, Switzerland.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Hugonnet
authors.forename: Philippe
authors.initials: P
authors.lastname: Eggimann
authors.forename: Hugo
authors.initials: H
authors.lastname: Sax
authors.forename: Sylvie
authors.initials: S
authors.lastname: Touveneau
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Chevrolet
authors.forename: Didier
authors.initials: D
authors.lastname: Pittet
mesh_terms: D000359:Aftercare / Q000379:methods*; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D007362:Intensive Care Units; D011159:Population Surveillance; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013557:Switzerland / Q000453:epidemiology