scholarly journals Evaluation of the surveillance system for undiagnosed serious infectious illness (USII) in intensive care units, England, 2011 to 2013

2014 ◽  
Vol 19 (46) ◽  
Author(s):  
G Dabrera ◽  
B Said ◽  
H Kirkbride ◽  
Collective On behalf of the USII Collaborating Group
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Surveillance System ◽  
Background Level ◽  
Mass Gathering ◽  
Emerging Infections ◽  
London 2012 ◽  
Large Numbers ◽  
Surveillance Model ◽  
Infectious Illness

Emerging infections are a potential risk during mass gathering events due to the congregation of large numbers of international travellers. To mitigate this risk for the London 2012 Olympic and Paralympic Games, a sentinel surveillance system was developed to identify clusters of emerging infections presenting as undiagnosed serious infectious illness (USII) in intensive care units (ICUs). Following a six month pilot period, which had begun in January 2011, the surveillance was operational for a further 18 months spanning the Games. The surveillance system and reported USII cases were reviewed and evaluated after this 18 month operational period including assessment of positive predictive value (PPV), timeliness, acceptability and sensitivity of the system. Surveillance records were used to review reported cases and calculate the PPV and median reporting times of USII surveillance. Sensitivity was assessed through comparison with the pilot period. Participating clinicians completed a five-point Likert scale questionnaire about the acceptability of surveillance. Between 11 July 2011 and 10 January 2013, 34 cases were reported. Of these, 22 remained classified as USII at the time of the evaluation, none of which were still hospitalised. No clusters were identified. The 22 USII cases had no association with the Games, suggesting that they represented the background level of USII in the area covered by the surveillance. This corresponded to an annualised rate of 0.39 cases/100,000 population and a PPV of 65%. Clinicians involved in the surveillance reported high acceptability levels. The USII surveillance model could be a useful public health tool in other countries and during mass gathering events for identifying potential clusters of emerging infections.

scholarly journals A new surveillance system for undiagnosed serious infectious illness for the London 2012 Olympic and Paralympic Games

2012 ◽  
Vol 17 (31) ◽  
Author(s):  
E Heinsbroek ◽  
B Said ◽  
H Kirkbride ◽  
Collective On behalf of the HPA USII Steering Group
Keyword(s):  
Intensive Care ◽  
Pilot Study ◽  
Intensive Care Units ◽  
Surveillance System ◽  
Emerging Infections ◽  
London 2012 ◽  
Reporting Tool ◽  
Infectious Illness ◽  
Paediatric Intensive Care Units ◽  
Paralympic Games

A new surveillance system was developed to detect possible new or emerging infections presenting as undiagnosed serious infectious illness (USII) for use during the London 2012 Olympic and Paralympic Games. Designated clinicians in sentinel adult and paediatric intensive care units (ICU/PICUs) reported USII using an online reporting tool or provided a weekly nil notification. Reported cases were investigated for epidemiological links. A pilot study was undertaken for six months between January and July 2011 to evaluate the feasibility and acceptability of the system. In this six-month period, 5 adults and 13 children were reported by six participating units (3 ICUs, 3 PICUs). Of these 18 patients, 12 were reported within four days after admission to an ICU/PICU. Nine patients were subsequently diagnosed and were thus excluded from the surveillance. Therefore, only nine cases of USII were reported. No clustering was identified. On the basis of the pilot study, we conclude that the system is able to detect cases of USII and is feasible and acceptable to users. USII surveillance has been extended to a total of 19 sentinel units in London and the south-east of England during the London 2012 Olympic and Paralympic Games.

scholarly journals Challenges with Surveillance of Healthcare-Associated Infections in Intensive Care Units in South Africa

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Saajida Mahomed ◽  
Ozayr Mahomed ◽  
A. Willem Sturm ◽  
Stephen Knight ◽  
Prashini Moodley
Keyword(s):  
South Africa ◽  
Organizational Culture ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Surveillance System ◽  
Health Sector ◽  
Central Line ◽  
Healthcare Associated Infections ◽  
Extensive Consultation ◽  
Healthcare Associated

Background. The incidence of healthcare-associated infections (HAIs) in the public health sector in South Africa is not known due to the lack of a surveillance system. We report on the challenges experienced in the implementation of a surveillance system for HAIs in intensive care units (ICUs). Methods. A passive, paper-based surveillance system was piloted in eight ICUs to measure the incidence of ventilator-associated pneumonia, catheter-associated urinary tract infection, and central line-associated bloodstream infection. Extensive consultation with the ICU clinical and nursing managers informed the development of the surveillance system. The Plan-Do-Study-Act method was utilized to guide the implementation of the surveillance. Results. The intended outputs of the surveillance system were not fully realized due to incomplete data. The organizational culture did not promote the collection of surveillance data. Nurses felt that the surveillance form added to their workload, and the infection control practitioners were unable to adequately supervise the process due to competing work demands. Conclusions. A manual system that adds to the administrative workload of nurses is not an effective method of measuring the burden of HAIs. Change management is required to promote an organizational culture that supports accurate data collection for HAIs.

Reproducibility of the Surveillance Effect to Decrease Nosocomial Infection Rates

2009 ◽  
Vol 30 (10) ◽  
pp. 993-999 ◽  
Author(s):  
P. Gastmeier ◽  
F. Schwab ◽  
D. Sohr ◽  
M. Behnke ◽  
C. Geffers
Keyword(s):  
Intensive Care ◽  
Nosocomial Infection ◽  
Intensive Care Units ◽  
Surveillance System ◽  
Knee Prosthesis ◽  
Venous Catheter ◽  
Infection Rates ◽  
Relative Risks ◽  
Infection Surveillance ◽  
Reduction Effect

Objective.To investigate whether the reduction effect due to participation in a nosocomial infection surveillance system for laboratory-confirmed central venous catheter (CVC)-associated primary bloodstream infection (BSI), ventilator-associated pneumonia (VAP), and surgical site infection (SSI) is reproducible for different time periods, independent of confounding factors that might occur during a specific time period.Methods.Data from the German national nosocomial infection surveillance system from the period January 1997 through June 2008 were used. CVC-associated BSI data and SSI data were analyzed for 3 starting periods, and VAP data were analyzed for 2 starting periods. Monthly infection rates were calculated for the following 36 months, and relative risks comparing the first and third surveillance years of each period were calculated.Results.A total of 2,399 CVC-associated BSI cases from 267 intensive care units, 3,637 VAP cases from 150 intensive care units, and 829 SSIs following 3 different procedures from 113 departments were analyzed. A significant reduction in VAP was shown for both starting periods investigated (overall relative risk [RR], 0.80 [95% CI, 0.74-0.86]). A significant reduction in CVC-associated BSI was demonstrated for 2 of 3 starting periods (overall RR, 0.83 [95% CI, 0.75-0.91]). A significant reduction in SSI was found for 2 starting periods for knee prosthesis insertion (overall RR, 0.56 [95% CI, 0.38-0.82]), for all of the 3 starting periods for cesarean delivery (overall RR, 0.75 [95% CI, 0.61-0.93]), and for none of the 3 starting periods for endoscopically performed cholecystectomy (overall RR, 0.89 [95% CI, 0.62-1.27]).Conclusions.The surveillance effect, manifest as a significant reduction of nosocomial infection rates between the first and third years of participation in a surveillance system, was observed independently from the calendar year in which the surveillance activities started.

scholarly journals Surveillance system of severe influenza cases admitted to the regional ICU,2009-2015

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Esra Morvan ◽  
Joanna Parra ◽  
Gerard Roy ◽  
Dominique Jeannel
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Surveillance System ◽  
Influenza Viruses ◽  
H3n2 Virus ◽  
Severe Influenza ◽  
Populations At Risk ◽  
Influenza A H1n1 ◽  
Capture Recapture

ObjectiveThe study aimed at: i) analyses the regional characteristics and riskfactors of severe influenza, taking into account dominant circulatingvirus(es) ii) estimate the regional completeness of the surveillancesystem.IntroductionEvery year, circulating influenza viruses generate a significantnumber of deaths. During the 2009 pandemic influenza A(H1N1),a national non mandatory surveillance system of severe influenzacases admitted to intensive care units(ICU) was set up in France.This surveillance is regionally driven by the regional offices (CIRE)of Santé publique France, the French Public Health Agency. Thisreport provides epidemiologic analysis of the recorded data sincethe implementation of surveillance in the Centre-Val de Loire regionover seasons 2009-10 to 2015-16 in regard of influenza epidemicsdynamics.MethodsSurveillance was carried out each year from October to April.Descriptive and analytic analyses were conducted to comparepopulation characteristics, pre-existing risk factors and the clinicaldata according to influenza season and dominant circulatinginfluenza virus(es). Logistic regressions were performed to identifyfactors associated with an increased risk of acute respiratory distresssyndrome (ARDS) or death. Two capture-recapture analyses wereperformed to establish the completeness of the surveillance systemin the region. The first one was realized on all cases, using two datasources (hospital records/surveillance data) and the second one, onlyon deaths, using three data sources(additional source: medical deathcertificates).ResultsFrom 2009-10 to 2015-16, the outbreak of influenza epidemicswas started more and more late. The number of severe influenzacases reported in the Loire Valley varied from 19 in 2010-11 to 75 in2014-15. Overall, the most affected population was adults, from 41%in 2011-12 to 83% in 2009-10. However seniors (more than 65 yearsold) represented an important part of patients during three epidemics:50% in 2011-12 and around 45% during the two last seasons;during these epidemics, men, (60%-68%), were more affected thanwomen. Patients’ pre-existing risk factors were mainly: being olderthan 65 years old and suffering of cardiac or pulmonary diseases.The comparison by dominant viruses over the seasons revealed thatwhen A(H1N1) virus prevailed, severe influenza occurred mainlyin adults patients with any type of pre-existing risk factors whereaswhen A(H3N2) virus prevailed, seniors with pre-existing pulmonarydisease were the most affected. More than a third of patientsdeclared an ARDS. The overall observed lethality was close to 16%.ARDS occurred more frequently in patients who were middle-aged(45-64 years), immunocompromised or infected with A(H1N1).Pre-existing pulmonary disease was a protective factor. Risk factorsassociated with death were being older than 65 years, male and havingdeclared an ARDS. The completeness of this surveillance system wasestimated by capture-recapture methods at 59% for severe influenzacases and 40% for death cases.ConclusionsThe epidemiology of severe influenza and epidemics dynamics inthe Centre-Val de Loire follow the national trends. Every season ischaracterized by the same dominant virus at national and regionallevels in intensive care units. Influenza epidemics 2009-10 and2014-15 were particularly long and severe, the first dominatedby the A(H1N1)pdm09 virus and the second by the A(H3N2).Our study has demonstrated that the populations at risk of severeinfluenza differ according to the circulating virus(es). Accordingto the obtained estimations, the completeness of the surveillancesystem, based on voluntary report by physicians, can be consideredas satisfactory. Regarding influenza deaths relatively low percentageof completeness may be explained by the fact that two sources arehospital based whereas the third one, medical death certificates,includes all influenzadeaths with no information on the death place.Many patients were not vaccinated or their status was unknown. Mostcases admitted to ICU presented pre-existing risk factors includedin eligibility criteria in influenza vaccination policies. This studyoutlines the importance of vaccination as the first prevention measure.

Establishment of a National Surveillance System for Alcohol-Based Hand Rub Consumption and Change in Consumption over 4 Years

2012 ◽  
Vol 33 (6) ◽  
pp. 618-620 ◽  
Author(s):  
Michael Behnke ◽  
Petra Gastmeier ◽  
Christine Geffers ◽  
Nadine Mönch ◽  
Christiane Reichardt
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Surveillance System ◽  
National Surveillance ◽  
Median Increase ◽  
National Surveillance System

Germany established a national surveillance system for alcohol-based hand rub consumption (AHC) in 2008. In 2010, the median AHC was 83 mL/patient-day in 543 intensive care units (ICUs) and 18 mL/patient-day in 4,638 non-ICUs. There was a median increase in AHC of 35.9% (P < .01) in 159 hospitals that participated in the surveillance system for 4 years.

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