title: The Validation of a Novel Surveillance System for Monitoring Bloodstream Infections in the Calgary Zone.
abstract: Background. Electronic surveillance systems (ESSs) that utilize existing information in databases are more efficient than conventional infection surveillance methods. The objective was to assess an ESS for bloodstream infections (BSIs) in the Calgary Zone for its agreement with traditional medical record review. Methods. The ESS was developed by linking related data from regional laboratory and hospital administrative databases and using set definitions for excluding contaminants and duplicate isolates. Infections were classified as hospital-acquired (HA), healthcare-associated community-onset (HCA), or community-acquired (CA). A random sample of patients from the ESS was then compared with independent medical record review. Results. Among the 308 patients selected for comparative review, the ESS identified 318 episodes of BSI of which 130 (40.9%) were CA, 98 (30.8%) were HCA, and 90 (28.3%) were HA. Medical record review identified 313 episodes of which 136 (43.4%) were CA, 97 (30.9%) were HCA, and 80 (25.6%) were HA. Episodes of BSI were concordant in 304 (97%) cases. Overall, there was 85.5% agreement between ESS and medical record review for the classification of where BSIs were acquired (kappa = 0.78, 95% Confidence Interval: 0.75-0.80). Conclusion. This novel ESS identified and classified BSIs with a high degree of accuracy. This system requires additional linkages with other related databases.
authors.affiliation: Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, TRW Building, Rm 3D10, Calgary, AB, Canada T2N 4Z6; Division of Microbiology, Calgary Laboratory Services, 9-3535 Research Road NW, Calgary, AB, Canada T2L 2K8.
authors.forename: Jenine R
authors.initials: JR
authors.lastname: Leal
authors.affiliation: Division of Microbiology, Calgary Laboratory Services, 9-3535 Research Road NW, Calgary, AB, Canada T2L 2K8; Department of Medicine, Health Sciences Centre, University of Calgary, Foothills Campus, 3330 Hospital Drive NW, Calgary, AB, Canada T2N 4N1; Department of Pathology and Laboratory Medicine, Diagnostic & Scientific Centre, 9-3535 Research Road NW, Calgary, AB, Canada T2L 2K8.
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Gregson
authors.affiliation: Division of Microbiology, Calgary Laboratory Services, 9-3535 Research Road NW, Calgary, AB, Canada T2L 2K8; Department of Medicine, Health Sciences Centre, University of Calgary, Foothills Campus, 3330 Hospital Drive NW, Calgary, AB, Canada T2N 4N1; Department of Pathology and Laboratory Medicine, Diagnostic & Scientific Centre, 9-3535 Research Road NW, Calgary, AB, Canada T2L 2K8.
authors.forename: Deirdre L
authors.initials: DL
authors.lastname: Church
authors.affiliation: Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, TRW Building, Rm 3D10, Calgary, AB, Canada T2N 4Z6.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Henderson
authors.affiliation: Division of Microbiology, Calgary Laboratory Services, 9-3535 Research Road NW, Calgary, AB, Canada T2L 2K8; Centre for Antimicrobial Resistance, University of Calgary, Alberta Health Services, Calgary Laboratory Services, 3330 Hospital Drive NW, B07 HMRB, Calgary, AB, Canada T2N 4N1.
authors.forename: Terry
authors.initials: T
authors.lastname: Ross
authors.affiliation: Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, TRW Building, Rm 3D10, Calgary, AB, Canada T2N 4Z6; Department of Medicine, Health Sciences Centre, University of Calgary, Foothills Campus, 3330 Hospital Drive NW, Calgary, AB, Canada T2N 4N1; Department of Pathology and Laboratory Medicine, Diagnostic & Scientific Centre, 9-3535 Research Road NW, Calgary, AB, Canada T2L 2K8; Centre for Antimicrobial Resistance, University of Calgary, Alberta Health Services, Calgary Laboratory Services, 3330 Hospital Drive NW, B07 HMRB, Calgary, AB, Canada T2N 4N1.
authors.forename: Kevin B
authors.initials: KB
authors.lastname: Laupland