An integrated computer-based infection surveillance program for infection control

AbstractDuring the past 30 years, many important strides have been made in the prevention of nosocomial infections in the United States. Infection control programs have been established in hospitals throughout the country. Techniques for surveillance of nosocomial infections have been developed and utilized extensively. Results of the Study on the Efficacy of Nosocomial Infection Control (SENIC Project) and the experience with surveillance of surgical wound infections have documented the fact that surveillance is an integral component of an effective nosocomial infection control program. In recent years, a number of approaches to nosocomial infection surveillance have been proposed as alternatives to comprehensive or hospital-wide surveillance. In 1986, four surveillance components were introduced in the National Nosocomial Infections Surveillance (NNIS) system to provide participating institutions the option to tailor their surveillance program to their local needs and priorities while continuing to provide information to the national database on nosocomial infections. Infection control practitioners currently face a challenge to develop more meaningful nosocomial infection rates to permit identification of new infection control priorities for their institution and to assess progress toward specific prevention objectives.

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Evaluation of a cesarean section postoperative wound infection surveillance program at Kenézy Hospital, Debrecen, Hungary

Orvosi Hetilap ◽

10.1556/oh.2011.28979 ◽

2011 ◽

Vol 152 (1) ◽

pp. 14-22 ◽

Cited By ~ 1

Author(s):

István Várkonyi ◽

Ildikó Makai ◽

Gyöngyi Papdiné Nyíri ◽

György Bacskó ◽

László Kardos

Keyword(s):

Cesarean Section ◽

Infection Control ◽

Wound Infection ◽

Prophylactic Antibiotic ◽

Antibiotic Use ◽

Infection Control Practice ◽

Surveillance Program ◽

Control Practice ◽

Infection Surveillance ◽

Prophylactic Measures

Wound infection is a typical, partly preventable complication of cesarean sections. We started extended recording of cesarean section data in October, 2008 as part of our general wound infection surveillance program. Aim: To describe the circumstances and outcomes of the sections and analyze associations between them. Methods: We analyzed 523 cases over the period October 1, 2008 to September 30, 2009. Variables were assessed using descriptive statistics. Associations between explanatory factors and wound infection were evaluated using logistic regression. Results: Infections (overall rate: 3.6%) were more frequent in younger subjects, those with anemia, subcutaneous hematoma, in pregnancies with meconium stained or purulent amniotic fluid, and decreased to about a third after infection control was tightened. Conclusions: by being a proxy variable of factors with which wound infection is associated, age is a clinically valuable predictive variable. Good infection control practice is effective in preventing wound infections. The results are consistent with appropriate prescription practices of prophylactic antibiotic use, and with prophylactic measures being effective. Orv. Hetil., 2011, 152, 14–22.

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Surveillance Strategies: A Primer

Infection Control ◽

10.1017/s0195941700069782 ◽

1987 ◽

Vol 8 (11) ◽

pp. 459-464 ◽

Cited By ~ 8

Author(s):

Elias Abrutyn ◽

George H. Talbot

Keyword(s):

Nosocomial Infection ◽

Infection Control ◽

Control Measures ◽

Regulatory Agencies ◽

Surveillance Program ◽

Infection Rates ◽

Control Programs ◽

Infection Surveillance ◽

Surveillance Programs ◽

And Control

The Centers for Disease Control's Study on the Efficacy of Nosocomial Infection Control (SENIC) showed that infection surveillance and control activities are associated with a decrease in nosocomial infection rates. Moreover, the intensity of activity correlated with the magnitude of the fall in infection rates. These results, plus the guidelines of regulatory agencies, mandate that infection control programs conduct surveillance activities. However, absolute standards for the content and nature of surveillance programs have not been established, and many descriptions of different types of surveillance programs are available. In this primer, we describe the considerations involved in development of a surveillance program with emphasis on issues concerning data collection.Langmuir considers surveillance when applied to disease as meaning the collection of data, the analysis of those data, and the distribution of the resulting information to those needing to know. The definition implies that surveillance is observational and that surveillance activities should be clearly separated from other related activities such as control measures. The latter activities, including their initiation, approval, and funding, are administrative matters underpinned by a scientific base that are undertaken by the recipients of the surveillance data and their analyses. They should be clearly separated from surveillance activities per se. There is also the implication that action results from surveillance; surveillance without action should be abandoned.

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USE OF AN ELECTRONIC DATA WAREHOUSE TO ENHANCE CARDIAC SURGICAL SITE SURVEILLANCE AT A LARGE CANADIAN CENTRE

Clinical & Investigative Medicine ◽

10.25011/cim.v31i4.4824 ◽

2008 ◽

Vol 31 (4) ◽

pp. 21 ◽

Cited By ~ 3

Author(s):

G W Rose ◽

V R Roth ◽

K N Suh ◽

M Taljaard ◽

C Van Walraven ◽

...

Keyword(s):

Infection Control ◽

Surgical Site Infection ◽

Data Warehouse ◽

Stepwise Logistic Regression ◽

Site Infection ◽

Electronic Data ◽

Trigger Mechanism ◽

Trigger Tool ◽

Infection Surveillance ◽

Trigger Mechanisms

Background/Purpose: Surgical site infection surveillance to determineincidence is a key infection control activity. Case detection is labour-intensive, therefore most infection control programs use manual or simple electronic mechanisms to “trigger” chart review. However, such “trigger” mechanisms are also labour-intensive, and often of poor specificity. Our objective is to develop a complex trigger mechanism using data from an electronic data warehouse, to improve specificity of surveillance of surgical site infection compared to current trigger mechanisms. Methods: We will derive an electronic trigger tool for cardiac surgical site infection surveillance using a nested case-control design, among a cohort of all patients undergoing coronary artery bypass grafting, cardiac valve repairor replacement, or heart transplant at the University of Ottawa Heart Institute, from July 1 2004 to June 30 2007. We will perform a systematic literature review to identify potential trigger factors to include in the model, then construct the trigger tool by backwards stepwise logistic regression. The best-fit model will be used to calculate the probability of surgical site infection. We will select the threshold probability to use in surveillance by visual inspection of receiver-operator-characteristic curves. The accuracy of this electronic trigger mechanism will be compared to pre-existing manual and simple electronic mechanisms using relative true positive ratios and relative false positive ratios. Results/Conclusions: We have selected 200 cases of surgical site infection and 541 controls from among 3744 procedures performed during the study period. As of the date ofthis abstract we are still undertaking the systematic review.

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Infection surveillance in nursing homes in Stockholm County, Sweden, 2005 - 2014

International Journal of Infection Control ◽

10.3396/ijic.v12i3.019.16 ◽

2016 ◽

Vol 12 (3) ◽

Author(s):

Ann Tammelin

Keyword(s):

Nursing Homes ◽

Infection Control ◽

Urinary Catheter ◽

Clinical Signs ◽

Signs And Symptoms ◽

County Council ◽

Antibiotic Prescribing ◽

Viral Gastroenteritis ◽

Stockholm County ◽

Infection Surveillance

Swedish nursing homes are obliged to have a management system for systematic quality work including self-monitoring of which surveillance of infections is one part. The Department of Infection Control in Stockholm County Council has provided a simple system for infection surveillance to the nursing homes in Stockholm County since 2002. A form is filled in by registered nurses in the nursing homes at each episode of infection among the residents. A bacterial infection is defined by antibiotic prescribing and a viral infection by clinical signs and symptoms. Yearly reports of numbers of infections in each nursing home and calculated normalized figures for incidence, i.e. infections per 100 residents per year, as well as proportion of residents with urinary catheter are delivered to the medically responsible nurses in each municipality by the Department of Infection Control. Number of included residents has varied from 4,531 in 2005 to 8,157 in 2014 with a peak of 10,051 in 2009. The yearly incidences during 2005 - 2014 (cases per 100 residents) were: Urinary tract infection (UTI) 7.9-16.0, Pneumonia 3.7-5.3, Infection of chronic ulcer 3.4–6.8, Other infection in skin or soft tissue 1.4–2.9, Clostridium difficile-infection 0.2–0.7, Influenza 0–0.4 and Viral gastroenteritis 1.2–3.7. About 1 % of the residents have a suprapubic urinary catheter, 6–7 % have an indwelling urinary catheter. Knowledge about the incidence of UTI has contributed to the decrease of this infection both in residents with and without urinary catheter.

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P17.23 A Real Time Computer Based Nosocomial Infection Surveillance System

Journal of Hospital Infection ◽

10.1016/s0195-6701(06)60294-6 ◽

2006 ◽

Vol 64 ◽

pp. S88-S89

Author(s):

J.A. Alava ◽

C. Ezpeleta ◽

I. Atutxa ◽

C. Busto ◽

E. Gómez ◽

...

Keyword(s):

Nosocomial Infection ◽

Real Time ◽

Surveillance System ◽

Infection Surveillance ◽

Computer Based

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Cerebrospinal Fluid Shunt-Associated Surgical Site Infection With Three- Versus Twelve-Month Follow-Up in Canadian Hospitals

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.679 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s157-s157

Author(s):

Kelly Baekyung Choi ◽

John Conly ◽

Blanda Chow ◽

Joanne Embree ◽

Bonita Lee ◽

...

Keyword(s):

Surgical Site Infection ◽

Age Distribution ◽

Patient Characteristics ◽

Csf Shunt ◽

Surveillance Program ◽

Site Infection ◽

Infection Surveillance ◽

Surgical Manipulation ◽

National Systems

Background: Surgical site infection (SSI) after cerebrospinal fluids (CSF) shunt surgery is thought to be acquired intraoperatively. Biomaterial-associated infection can present up to 1 year after surgery, but many national systems have shortened follow-up to 90 days. We compared 3- versus 12-month follow-up periods to determine the nature of case ascertainment in the 2 periods. Methods: Participants of any age with placement of an internal CSF shunt or revision surgical manipulation of an existing internal shunt identified in the Canadian Nosocomial Infection Surveillance Program (CNISP) participating hospitals between 2006 and 2018 were eligible. We excluded patients with external shunting devices or culture-positive CSF at the time of surgery. Patients were followed for 12 months after surgery for the primary outcome of a CSF infection with a positive CSF culture by review of laboratory and health records. Patients were categorized as adult (aged ≥18 years) or pediatric (aged < 18 years). The infection rate was expressed as the number of CSF shunt-associated infections divided by the number of shunt surgeries per 100 procedures. Results: In total, 325 patients (53% female) met inclusion criteria in 14 hospitals from 7 provinces were identified. Overall, 46.1% of surgeries were shunt revisions and 90.3% of shunts were ventriculoperitoneal. For pediatric patients, the median age was 0.7 years (IQR, 0.2–7.0). For adult patients, the median age was 47.9 years (IQR, 29.6–64.6). The SSI rates per 100 procedures were 3.69 for adults and 3.65 for pediatrics. The overall SSI rates per 100 procedures at 3 and 12 months were 2.74 (n = 265) and 3.48 (n = 323), respectively. By 3 months (90 days), 82% of infection cases were identified (Fig. 1). The median time from procedure to SSI detection was 30 days (IQR, 10–65). No difference was found in the microbiology of the shunt infections at 3- and 12-month follow-ups. The most common pathogens were coagulase-negative Staphylococcus (43.6 %), followed by S. aureus (24.8 %) and Propionibacterium spp (6.5 %). No differences in age distribution, gender, surgery type (new or revision), shunt type, or infecting organisms were observed when 3- and 12-month periods were compared. Conclusions: CSF-SSI surveillance for 3 versus 12 months would capture 82.0% (95% CI, 77.5–86.0) of cases, with no significant differences in the patient characteristics, surgery types, or pathogens. A 3-month follow-up can reduce resources and allow for more timely reporting of infection rates.Funding: NoneDisclosures: None

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N-CDAD in Canada: Results of the Canadian Nosocomial Infection Surveillance Program 1997 N-CDAD Prevalence Surveillance Project

Canadian Journal of Infectious Diseases ◽

10.1155/2001/304098 ◽

2001 ◽

Vol 12 (2) ◽

pp. 81-88 ◽

Cited By ~ 9

Author(s):

Meaghen Hyland ◽

Marianna Ofner-Agostini ◽

Mark Miller ◽

Shirley Paton ◽

Marie Gourdeau ◽

...

Keyword(s):

Health Care ◽

Nosocomial Infection ◽

Toxin Production ◽

Health Care Facilities ◽

Surveillance Program ◽

Prevention Measures ◽

Case Definitions ◽

Infection Surveillance ◽

Positive Stool ◽

The Impact

BACKGROUND:A 1996 preproject survey among Canadian Hospital Epidemiology Committee (CHEC) sites revealed variations in the prevention, detection, management and surveillance ofClostridium difficile-associated diarrhea (CDAD). Facilities wanted to establish national rates of nosocomially acquired CDAD (N-CDAD) to understand the impact of control or prevention measures, and the burden of N-CDAD on health care resources. The CHEC, in collaboration with the Laboratory Centre for Disease Control (Health Canada) and under the Canadian Nosocomial Infection Surveillance Program, undertook a prevalence surveillance project among selected hospitals throughout Canada.OBJECTIVE:To establish national prevalence rates of N-CDAD.METHODS:For six weeks in 1997, selected CHEC sites tested all diarrheal stools from inpatients for eitherC difficiletoxin orC difficilebacteria with evidence of toxin production. Questionnaires were completed for patients with positive stool assays who met the case definitions.RESULTS:Nineteen health care facilities in eight provinces participated in the project. The overall prevalence of N-CDAD was 13.0% (95% CI 9.5% to 16.5%). The mean number of N-CDAD cases were 66.3 cases/100,000 patient days (95% CI

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