Hospital-acquired pneumonia surveillance—an unmet need

Ewan, Victoria; Witham, Miles D.; Kiernan, Martin; Simpson, A. John

doi:10.1016/s2213-2600(17)30296-5

Cited by 14 publications

(6 citation statements)

References 7 publications

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“…Although nvHAP is more frequent, and has been shown to be comparable in mortality and costs to VAP [3], current research, prevention guidelines, and prevention efforts focus almost exclusively on VAP. In 2017, Ewan et al called nvHAP a 'neglected disease' among HAIs [4]. As a fundamental first step to preventing nvHAP, they argued for obtaining accurate estimates of prevalence and incidence through prospective surveillance [4].…”

Section: Introductionmentioning

confidence: 99%

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Development and validation of a semi-automated surveillance system—lowering the fruit for non-ventilator-associated hospital-acquired pneumonia (nvHAP) prevention

Wolfensberger

Jakob²,

Hesse

et al. 2019

Clinical Microbiology and Infection

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a b s t r a c tObjectives: Conducting manual surveillance of non-ventilator-associated hospital-acquired pneumonia (nvHAP) using ECDC (European Centre for Disease Prevention and Control) surveillance criteria is very resource intensive. We developed and validated a semi-automated surveillance system for nvHAP, and describe nvHAP incidence and aetiology at our hospital. Methods: We applied an automated classification algorithm mirroring ECDC definition criteria to distinguish patients 'not at risk' from patients 'at risk' for suffering from nvHAP. 'At risk'-patients were manually screened for nvHAP. For validation, we applied the reference standard of full manual evaluation to three validation samples comprising 2091 patients. Results: Among the 39 519 University Hospital Zurich inpatient discharges in 2017, the algorithm identified 2454 'at-risk' patients, reducing the number of medical records to be manually screened by 93.8%. From this subset, nvHAP was identified in 251 patients (0.64%, 95%CI: 0.57e0.73). Sensitivity, negative predictive value, and accuracy of semi-automated surveillance versus full manual surveillance were lowest in the validation sample consisting of patients with HAP according to the International Classification of Diseases (ICD-10) discharge diagnostic codes, with 97.5% (CI: 93.7e99.3%), 99.2% (CI: 97.9 e99.8%), and 99.4% (CI: 98.4e99.8%), respectively. The overall incidence rate of nvHAP was 0.83/1000 patient days (95%CI: 0.73e0.94), with highest rates in haematology/oncology, cardiac and thoracic surgery, and internal medicine including subspecialties. Conclusions: The semi-automated surveillance demonstrated a very high sensitivity, negative predictive value, and accuracy. This approach significantly reduces manual surveillance workload, thus making continuous nvHAP surveillance feasible as a pivotal element for successful prevention efforts.

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Section: Introductionmentioning

confidence: 99%

“…In 2017, Ewan et al called nvHAP a 'neglected disease' among HAIs [4]. As a fundamental first step to preventing nvHAP, they argued for obtaining accurate estimates of prevalence and incidence through prospective surveillance [4].…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a semi-automated surveillance system—lowering the fruit for non-ventilator-associated hospital-acquired pneumonia (nvHAP) prevention

Wolfensberger

Jakob²,

Hesse

et al. 2019

Clinical Microbiology and Infection

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“…Some investigators have called for increased attention and resources for this underappreciated health care associated infection. [15][16][17] The majority of pneumonia events in hospitals in our survey were not ventilator-associated.…”

Section: Discussionmentioning

confidence: 99%

Decreased Hospital-Acquired Respiratory Infections among elder Inpatients in General Hospital during the COVID-19 Pandemic

Li¹,

Zhao²,

Chen³

et al. 2023

Preprint

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Background In order to avoid nosocomial transmission of COVID-19, various prevention and control measures have been strictly implemented in medical institutions. These strict measures can probably reduce the incidence of hospital acquired respiratory infections. We conducted this study to assess changes in the prevalence of hospital acquired respiratory infections during a period of national attention to the prevention the COVID-19 pandemic. Methods We retrospectively analyzed the clinical data of patients from October to December 2019 and from October to December 2020. The diagnostic of hospital acquired respiratory infections was based on CDC/NHSN criteria. We compared the incidence and mortality rate of hospital acquired respiratory infections between these 2 periods. We also used multivariate logistics regression analysis for risk factors associated with mortality. Results In 2020, a total of 2921 patients’ data were surveyed, as compared with 2211 patients in 2019. Incidence of hospital acquired respiratory infections was lower in 2020 (2.9% vs. 4.7%, P = 0.001). In hospital mortality of patients with hospital acquired respiratory infections had no significant difference (38.4% vs. 30.5%, p = 0.252). Multivariate logistics regression analysis showed that severe pneumonia (RR = 28.235, 95%CI: 10.122, 78.759, p = 0.000), previous malignant tumor (RR = 4.599, 95%CI: 1.768, 11.963, p = 0.002) and cardiac injury (RR = 2.264, 95%CI: 0.935, 5.485, p = 0.07) were associated with an increased risk of mortality. Conclusions The incidence of hospital acquired respiratory tract infections was significantly decreased during COVID-19 period as a result of the adoption of infection prevention and control measures in medical institutions. Elder patients with severe pneumonia and previous malignant tumor were at high risk for death in hospital.

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“…However, non-ventilated patients can also develop HARTI, non-ventilator associated HARTI (NVA-HARTI). While ventilator-associated infections, especially ventilator-associated pneumonia (VAP), have been extensively studied and their incidence, risk factors, and outcomes widely reported (1,2), very little in this regard is known about NVA-HARTI in ICU patients (3,4), and some scientists call it a 'neglected disease' (5). Simultaneously, according to the most recent USA point prevalence survey, pneumonia in non-ventilated patients constitutes the majority of healthcare-associated pneumonia cases in U.S. hospitals (6).…”

Section: Introductionmentioning

confidence: 99%

The incidence and outcomes of healthcare-associated respiratory tract infections in non-ventilated neurocritical care patients: Results of a 10-year cohort study

Ershova

Савин

Хоменко

et al. 2022

Journal of Clinical Neuroscience

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Hospital-acquired pneumonia surveillance—an unmet need

Cited by 14 publications

References 7 publications

Development and validation of a semi-automated surveillance system—lowering the fruit for non-ventilator-associated hospital-acquired pneumonia (nvHAP) prevention

Development and validation of a semi-automated surveillance system—lowering the fruit for non-ventilator-associated hospital-acquired pneumonia (nvHAP) prevention

Decreased Hospital-Acquired Respiratory Infections among elder Inpatients in General Hospital during the COVID-19 Pandemic

The incidence and outcomes of healthcare-associated respiratory tract infections in non-ventilated neurocritical care patients: Results of a 10-year cohort study

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