ICU infection surveillance can be based on electronic routine data: results of a case study

Abstract

Background The surveillance of hospital-acquired infections in Germany is usually conducted via manual chart review; this, however, proves resource intensive and is prone to a certain degree of subjectivity. Documentation based on electronic routine data may present an alternative to manual methods. We compared the data derived via manual chart review to that which was derived from electronic routine data. Methods Data used for the analyses was obtained from five of the University of Leipzig Medical Center’s (ULMC) ICUs. Clinical data was collected according to the Protection against Infection Act (IfSG); documentation thereof was carried out in hospital information systems (HIS) as well as in the ICU-KISS module provided by the National Reference Center for the Surveillance of Nosocomial Infections (NRZ). Algorithmically derived data was generated via an algorithm developed in the EFFECT study; ward-movement data was linked with microbiological test results, generating a data set that allows for evaluation as to whether or not an infection was ICU-acquired. Results Approximately 75% of MDRO cases and 85% of cases of sepsis/primary bacteremia were classified as ICU-acquired by both manual chart review and EFFECT. Most discrepancies between the manual and algorithmic approaches were due to differentiating definitions regarding the patients’ time at risk for acquiring MDRO/bacteremia. Conclusions The concordance between manual chart review and algorithmically generated data was considerable. This study shows that hospital infection surveillance based on electronically generated routine data may be a worthwhile and sustainable alternative to manual chart review.

Innovative Techniques for Infection Control and Surveillance in Hospital Settings and Long-Term Care Facilities: A Scoping Review

“…Despite the year of publication, we also observed the last year in which the study was conducted. We observed that most of the studies were conducted in 2019 (n = 7, [10,18,20,31,37,41,57]), followed by 2017 (n = 6, [14,22,23,33,44,55,56]), 2018 (n = 6, [17,28,32,34,42,43]), and 2020 (n = 6, [11,15,21,26,27,48]). Only a few studies were conducted in earlier and later years (2021 = 4 [18,24,40,46]; 2022 = 3 [29,30,39]; 2016 = 1 [16]; 2015 = 3 [35,36,38]; 2014 = 1 [19]; 2013 = 2 [12,49]; 2012 = 1 [45]; 2010 = 1 [13]; Unknown = 1 [47]).…”

“…For the 43 studies included in the analysis [55][56][57], most (n = 16) were published in the last year [11,15,17,18,20,21,26,[28][29][30]32,39,40,46,48,57], four in 2022 [24,31,34,42], six in 2021 [10,27,33,35,37,49], seven in 2020 [12,14,25,36,38,43,44], six in 2019 [13,22,23,41,55,56], and four in 2018 [16,19,45,47]. Despite the year of publication, we also observed the last year in which the study was conducted.…”

“…The mean duration of the studies was 43.7 months (median 38.5; IQR 12-68). The studies were conducted across multiple continents, with sixteen conducted in North America (fourteen in the US [10,14,16,17,19,20,23,34,38,42,[45][46][47]55] and two in Canada [26,35]); twenty-one in Europe (six in the UK, [24,27,29,30,36,57], four in Sweden [12,15,21,49], three in Germany [28,41,44], two in France [13,32] and Italy [37,43], and one each in the Netherlands [56], Spain [40], Norway [39], and Switzerland [11]); five in Asia (three in China [18,25,31], one in Pakistan [48], and one in Thailand [22]), and one in Africa (Rwanda [33]). The majority of studies were single-centre studies (n = 26, [10,11,1...…”

“…The majority of studies were single-centre studies (n = 26, [10,11,15,[17][18][19][21][22][23]25,28,31,[33][34][35][41][42][43][44][45][46][47][48][49]55,57] conducted in tertiary or university hospitals (n = 26, [10,11,13,[15][16][17][19][20][21][22][23][25][26][27]30,31,[33][34][35]40,42,45,46,48,49,56]). A small numbe...…”

“…Among the studies, 19 reported data from more or all hospital wards [10][11][12][13]15,16,24,25,29,[34][35][36]39,41,[44][45][46]49,57], while the rest collected data from specific wards: sixteen from single surgical wards (one paediatric [43], seven orthopaedic [18,23,26,32,40,55,56], three abdominal [21,27,48], one cardiac [30], three neurosurgical [17,22,31], one gynaecology [33]); four from ICUs [19,28,37,42]; and four from other wards [14,20,38,47]. Among the studies, 19 reported data from more or all hospital wards [10][11][12][13]15,…”