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Reproducibility of the Surveillance Effect to Decrease Nosocomial Infection Rates

Published online by Cambridge University Press:  02 January 2015

P. Gastmeier ,
F. Schwab ,
D. Sohr ,
M. Behnke  and
C. Geffers
P. Gastmeier*
Affiliation:
Institute of Hygiene and Environmental Medicine, Charité-University Medicine Berlin, Germany National Reference Centre for Surveillance of Nosocomial Infections, Germany
F. Schwab
Affiliation:
Institute of Hygiene and Environmental Medicine, Charité-University Medicine Berlin, Germany National Reference Centre for Surveillance of Nosocomial Infections, Germany
D. Sohr
Affiliation:
Institute of Hygiene and Environmental Medicine, Charité-University Medicine Berlin, Germany National Reference Centre for Surveillance of Nosocomial Infections, Germany
M. Behnke
Affiliation:
Institute of Hygiene and Environmental Medicine, Charité-University Medicine Berlin, Germany National Reference Centre for Surveillance of Nosocomial Infections, Germany
C. Geffers
Affiliation:
Institute of Hygiene and Environmental Medicine, Charité-University Medicine Berlin, Germany National Reference Centre for Surveillance of Nosocomial Infections, Germany
*
Institute of Hygiene and Environmental Medicine, Charité-University Medicine Berlin, Hindenburg-damm 27, D 12203 Berlin, Germany ([email protected])
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Abstract

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.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 30 , Issue 10 , October 2009 , pp. 993 - 999
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2009

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References

1.Brandt, C, Sohr, D, Behnke, M, Daschner, F, Rüden, H, Gastmeier, P. Reduction of surgical site infection rates associated with active surveillance. Infect Control Hosp Epidemiol 2006;27:1347–1351.CrossRefGoogle ScholarPubMed
2.Geubbels, ELPE, Nagelkerke, NJD, Mintjes-De Groot, AJ, Vandenbroucke-Grauls, CMJE, Grobbee, DE, De Boer, AS. Reduced risk of surgical site infections through surveillance in a network. Int J Qual Health Care 2006;18:127–133.Google Scholar
3.Rioux, C, Grandbastien, B, Astagneau, P. Impact of a six-year control programme on surgical site infections in France: results of the INCISO surveillance. J Hosp Infect 2007;66:217–223.Google Scholar
4.Courts, C, Rabilloud, M, Ecochard, R, et al.Nine-year downward trends in surgical site infection rate in southeast France (1995-2003). J Hosp Infect 2007;67:127–134.Google Scholar
5.Vincent, A, Ayzac, L, Girard, R, et al.Downward trends in surgical site and urinary tract infections after cesarean delivery in a French surveillance network, 1997-2003. Infect Control Hosp Epidemiol 2008;29:227–233.CrossRefGoogle Scholar
6.Schwab, F, Geffers, C, Bärwolff, S, Rüden, H, Gastmeier, P. Reducing neonatal nosocomial infections through participation in a national surveillance system. J Hosp Infect 2007;65:319–325.Google Scholar
7.Gastmeier, P, Geffers, C, Brandt, C, et al.Effectiveness of a nationwide nosocomial infection surveillance system for reducing nosocomial infections. J Hosp Infect 2006;64:16–22.Google Scholar
8.Garner, JS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections, 1988. Am J Infect Control 1988;16:128–140.Google Scholar
9.Horan, TC, Gaynes, RP, Mattone, WJ, Jarvis, WR, Emori, TG. CDC definitions of surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol 1992;13:606–608.Google Scholar
10.Emori, TG, Culver, DH, Horan, TC, et al.National Nosocomial Infections Surveillance system (NNIS): description of surveillance methodology. Am J Infect Control 1991;19:19–35.Google Scholar
11.Gastmeier, P, Sohr, D, Brandt, C, Eckmanns, T, Behnke, M, Rüden, H. Reduction of orthopaedic wound infections in 21 hospitals. Arch Orthop Trauma Surg 2005;125:526–530.Google Scholar
12.Bärwolff, S, Sohr, D, Geffers, C, et al.Reduction of surgical site infections after Caesarean delivery using surveillance. J Hosp Infect 2006;64:156–161.Google Scholar
13.Zuschneid, I, Schwab, F, Geffers, C, Behnke, M, Rüden, H, Gastmeier, P. Trends in ventilator-associated pneumonia rates within the German nosocomial infection surveillance system (KISS). Infect Control Hosp Epidemiol 2007;28:314–318.CrossRefGoogle ScholarPubMed
14.Horan, T, Gaynes, R. Surveillance of nosocomial infections. In: Mayhall, C, ed. Hospital Epidemiology and Infection Control. Atlanta, GA: Lippincott Williams & Wilkins; 2004:1659–1689.Google Scholar
15.Edwards, J, Peterson, K, Andrus, M, et al.National Healthcare Safety Network (NHSN) report, data summary for 2006, issued June 2007. Am J Infect Control 2007;35:290–301.Google Scholar
16.National Nosocomial Infections Surveillance System. National Nosocomial Infections Surveillance (NNIS) system report, data summary from January 1992-June 2004, issued October 2004. Am J Infect Control 2004;32:470–485.Google Scholar