title: Syndromic surveillance for evaluating the occurrence of healthcare-associated infections in equine hospitals.
abstract: BACKGROUND
  Methods that can be used to estimate rates of healthcare-associated infections and other nosocomial events have not been well established for use in equine hospitals. Traditional laboratory-based surveillance is expensive and cannot be applied in all of these settings.
  
  
  OBJECTIVE
  To evaluate the use of a syndromic surveillance system for estimating rates of occurrence of healthcare-associated infections among hospitalised equine cases.
  
  
  METHODS
  Multicentre, prospective longitudinal study.
  
  
  METHODS
  This study included weaned equids (n = 297) that were admitted for gastrointestinal disorders at one of 5 participating veterinary referral hospitals during a 12-week period in 2006. A survey form was completed by the primary clinician to summarise basic case information, procedures and treatments the horse received, and whether one or more of 7 predefined nosocomial syndromes were recognised at any point during hospitalisation. Adjusted rates of nosocomial events were estimated using Poisson regression. Risk factors associated with the risk of developing a nosocomial event were analysed using multivariable logistic regression.
  
  
  RESULTS
  Among the study population, 95 nosocomial events were reported to have occurred in 65 horses. Controlling for differences among hospitals, 19.7% (95% confidence interval, 14.5-26.7) of the study population was reported to have had at least one nosocomial event recognised during hospitalisation. The most commonly reported nosocomial syndromes that were unrelated to the reason for hospitalisation were surgical site inflammation and i.v. catheter site inflammation.
  
  
  CONCLUSIONS
  Syndromic surveillance systems can be standardised successfully for use across multiple hospitals without interfering with established organisational structures, in order to provide useful estimates of rates related to healthcare-associated infections.
authors.affiliation: College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, USA.
authors.forename: A A
authors.initials: AA
authors.lastname: Ruple-Czerniak
authors.forename: H W
authors.initials: HW
authors.lastname: Aceto
authors.forename: J B
authors.initials: JB
authors.lastname: Bender
authors.forename: M R
authors.initials: MR
authors.lastname: Paradis
authors.forename: S P
authors.initials: SP
authors.lastname: Shaw
authors.forename: D C
authors.initials: DC
authors.lastname: Van Metre
authors.forename: J S
authors.initials: JS
authors.lastname: Weese
authors.forename: D A
authors.initials: DA
authors.lastname: Wilson
authors.forename: J
authors.initials: J
authors.lastname: Wilson
authors.forename: P S
authors.initials: PS
authors.lastname: Morley
mesh_terms: D000818:Animals; D003428:Cross Infection / Q000453:epidemiology / Q000662:veterinary*; D062665:Epidemiological Monitoring / Q000662:veterinary; D006734:Horse Diseases / Q000382:microbiology*; D006736:Horses; D006762:Hospitals, Animal / Q000592:standards*; D008137:Longitudinal Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
keywords: adverse outcomes; biosecurity; horse; hospital-acquired infection; infection control; nosocomial infection