title: Laboratory-based management of microbiological alerts: effects of an automated system on the surveillance and treatment of nosocomial infections in an oncology hospital.
abstract: BACKGROUND
  Prevention and surveillance programs are key to contain Nosocomial Infections (Nis). At the European Institute of Oncology, surveillance based on ex-post data collection has been done since the inception of hospital activity; laboratory-based surveillance of microbiological alert was not standardized. This study describes the issues related to the recent introduction into the hospital routine of a laboratory-based automated surveillance system and its clinical impact on monitoring and treatment of Nis.
  
  
  METHODS
  An interdisciplinary team defined the alerts and the actions to be taken in response; recipients of the alert messages were identified and software was programmed. Program features were created so their employment would generate a prompt notification of clinically critical results. After a training period, the program was introduced in the hospital routine.
  
  
  RESULTS
  There were a total of 150 generated alerts; the main alert related to microorganisms requiring prompt patient isolation and/or public notification. Clinical use of the program was relevant in detection and immediate notification of Cytomegalovirus active infection in stem cell recipients and central venous catheter related candidemia: the prompt administration of adequate treatment was possible hours earlier compared to the previous approach.
  
  
  CONCLUSIONS
  A laboratory-based automated surveillance system is effective in facilitating the management of Nis; its clinical employment also leads to important clinical advantages in patient care.
authors.affiliation: Laboratory Medicine Unit, European Institute of Oncology, Via Ripamonti 435, 20141, Milano, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Passerini
authors.forename: R
authors.initials: R
authors.lastname: Biffi
authors.forename: D
authors.initials: D
authors.lastname: Riggio
authors.forename: S
authors.initials: S
authors.lastname: Pozzi
authors.forename: Mt
authors.initials: M
authors.lastname: Sandri