Assessment of a selective surveillance method for detecting nosocomial infections in patients in the intensive care department.
BACKGROUND
The implementation of a time- and cost-effective system for the surveillance of the nosocomial infection (NI) is a challenge for infection control practitioners.


OBJECTIVE
The aim of this study was to assess the sensitivity and the time reduction using a selective surveillance method (SSM) for the detection of NIs in comparison with a reference surveillance method (RSM).


METHODS
During a 12-month period, surveillance was performed prospectively in 4 intensive care departments on a rotating basis. Using the RSM, NIs were identified by prospective chart reviews performed twice a week combined with weekly infectious disease ward rounds. In the SSM, surveillance was reduced to microbiologic data and participation in the weekly infectious disease ward rounds followed by selective chart review.


RESULTS
In all, 578 patients amounting to 3597 patient-days were included in the study. In total, 78 NIs among 56 patients were identified. The overall sensitivity of the SSM compared with the RSM was 93.6% (73 of 78 NIs). The sensitivity of the SSM for the most important device-associated NIs (pneumonia, bloodstream infections, and urinary tract infections) was 96.3% (52 of 54 NIs) and 87.5% (21 of 24 NIs) for other NIs. Time required using the SSM was 1.3 hours compared with 4.1 hours per 10 beds per week (P =.0001) with the RSM.


CONCLUSIONS
Within our setting, a SSM with restriction to microbiology reports and participation in the infectious disease ward rounds detected NIs with a high sensitivity and a remarkable time reduction.
Zolldann
Dirk
D
Department of Infection Control, University Hospital, Aachen, Germany.
Haefner
Helga
H
Poetter
Carsten
C
Buzello
Shariah
S
Sohr
Dorit
D
Luetticken
Rudolf
R
Lemmen
Sebastian W
SW
Sohr
David
D
D003428:Cross Infection / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D005858:Germany / Q000453:epidemiology; D006801:Humans; D017053:Infection Control / Q000458:organization & administration*; D007362:Intensive Care Units; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018571:Sentinel Surveillance