title: Results from the first 12 months of the national surveillance of healthcare associated outbreaks in Germany, 2011/2012.
abstract: BACKGROUND
  In August 2011, the German Protection against Infection Act was amended, mandating the reporting of healthcare associated infection (HAI) outbreak notifications by all healthcare workers in Germany via local public health authorities and federal states to the Robert Koch Institute (RKI).
  
  
  OBJECTIVE
  To describe the reported HAI-outbreaks and the surveillance system's structure and capabilities.
  
  
  METHODS
  Information on each outbreak was collected using standard paper forms and notified to RKI. Notifications were screened daily and regularly analysed.
  
  
  RESULTS
  Between November 2011 and November 2012, 1,326 paper forms notified 578 HAI-outbreaks, between 7 and 116 outbreaks per month. The main causative agent was norovirus (n = 414/578; 72%). Among the 108 outbreaks caused by bacteria, the most frequent pathogens were Clostridium difficile (25%) Klebsiella spp. (19%) and Staphylococcus spp. (19%). Multidrug-resistant bacteria were responsible for 54/108 (50%) bacterial outbreaks. Hospitals were affected most frequently (485/578; 84%). Hospital outbreaks due to bacteria were mostly reported from intensive care units (ICUs) (45%), followed by internal medicine wards (16%).
  
  
  CONCLUSIONS
  The mandatory HAI-outbreak surveillance system describes common outbreaks. Pathogens with a particular high potential to cause large or severe outbreaks may be identified, enabling us to further focus research and preventive measures. Increasing the sensitivity and reliability of the data collection further will facilitate identification of outbreaks able to increase in size and severity, and guide specific control measures to interrupt their propagation.
authors.affiliation: Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany; Postgraduate Training for Applied Epidemiology, Berlin, Germany, affiliated to the European Programme for Intervention Epidemiology Training, European Centre for Disease Prevention and Control, Stockholm, Sweden.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Haller
authors.affiliation: Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
authors.forename: Tim
authors.initials: T
authors.lastname: Eckmanns
authors.affiliation: Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
authors.forename: Justus
authors.initials: J
authors.lastname: Benzler
authors.affiliation: Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
authors.forename: Kristin
authors.initials: K
authors.lastname: Tolksdorf
authors.affiliation: Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Claus
authors.affiliation: Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Gilsdorf
authors.affiliation: Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
authors.forename: Muna Abu
authors.initials: MA
authors.lastname: Sin
mesh_terms: D003140:Communicable Disease Control / Q000331:legislation & jurisprudence; D003428:Cross Infection / Q000453:epidemiology* / Q000266:history / Q000382:microbiology; D018563:Disease Notification / Q000266:history / Q000331:legislation & jurisprudence; D004196:Disease Outbreaks / Q000266:history; D005858:Germany / Q000453:epidemiology; D049674:History, 21st Century; D006801:Humans; D019221:Mandatory Reporting / Q000266:history; D011159:Population Surveillance; D012621:Seasons; D013997:Time Factors