Abstract
Hospital-acquired Infections (HAIs) surveillance, defined as the systematic collection of data related to a certain health event, is considered an essential dimension for a prevention HAI program to be effective. In recent years, new automated HAI surveillance methods have emerged with the wide adoption of electronic health records (EHR). Here we present the validation results against the gold standard of HAIs diagnosis of the InNoCBR system deployed in the Ourense University Hospital Complex (Spain). Acting as a totally autonomous system, InNoCBR achieves a HAI sensitivity of 70.83% and a specificity of 97.76%, with a positive predictive value of 77.24%. The kappa index for infection type classification is 0.67. Sensitivity varies depending on infection type, where bloodstream infection attains the best value (93.33%), whereas the respiratory infection could be improved the most (53.33%). Working as a semi-automatic system, InNoCBR reaches a high level of sensitivity (81.73%), specificity (99.47%), and a meritorious positive predictive value (94.33%).
Highlights
Hospital-acquired infections are defined as infections contracted in a hospital environment being not present, nor in the incubation period, at the inpatient admission date [1]
Hospital-acquired Infections (HAIs) surveillance, defined as the systematic collection of data related to a certain health event, is considered an essential dimension for a prevention HAI program to be effective
Gold standard fieldwork resulted in a valuable final raw data set comprising 938 possible HAI cases belonging to the 890 patients that conform the population under study in the analysed period
Summary
Hospital-acquired (nosocomial) infections are defined as infections contracted in a hospital environment being not present, nor in the incubation period, at the inpatient admission date [1]. Surveillance activities are a first step towards HAI prevention, showing that through the implementation of appropriate surveillance and control programs, a reduction of up to 20%–30% in the occurrence of HAIs can be achieved [4–6] As part of this approach, traditional surveillance is based on time-consuming manual inspections, which require (i) daily revision of lengthy lists containing micro-organisms found in positive cultures from the microbiology service and drug prescriptions from the pharmacy service, (ii) regular visits to the medical inpatient units, (iii) revision of the clinical histories (e.g., evolution records, annotations from nursing staff, analytical data, etc.,), and (iv) compute the necessary calculations for estimating the infection rate. While the BioMed Research International benefits of this traditional real-time surveillance are undeniable, this mode of operation is expensive and difficult to assume for the vast majority of the preventive medicine services, which o en see other relevant activities seriously undermined
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