Abstract
BackgroundWe aimed to develop a real-time nosocomial infection surveillance system (RT-NISS) to monitor all nosocomial infections (NIs) and outbreaks in a Chinese comprehensive hospital to better prevent and control NIs.MethodsThe screening algorithm used in RT-NISS included microbiological reports, antibiotic usage, serological and molecular testing, imaging reports, and fever history. The system could, in real-time, identify new NIs, record data, and produce time-series reports to align NI cases.ResultsCompared with a manual survey of NIs (the gold standard), the sensitivity and specificity of RT-NISS was 98.8% (84/85) and 93.0% (827/889), with time-saving efficiencies of about 200 times. RT-NISS obtained the highest hospital-wide monthly NI rate of 2.62%, while physician and medical record reviews reported rates of 1.52% and 2.35% respectively. It took about two hours for one infection control practitioner (ICP) to deal with 70 new suspicious NI cases; there were 3,500 inpatients each day in the study hospital. The system could also provide various updated data (i.e. the daily NI rate, surgical site infection (SSI) rate) for each ward, or the entire hospital. Within 3 years of implementing RT-NISS, the ICPs monitored and successfully controlled about 30 NI clusters and 4 outbreaks at the study hospital.ConclusionsJust like the “ICPs’ eyes”, RT-NISS was an essential and efficient tool for the day-to-day monitoring of all NIs and outbreak within the hospital; a task that would not have been accomplished through manual process.
Highlights
We aimed to develop a real-time nosocomial infection surveillance system (RT-NISS) to monitor all nosocomial infections (NIs) and outbreaks in a Chinese comprehensive hospital to better prevent and control NIs
The National Nosocomial Infections Surveillance system (NNIS) revealed that only 20% of NIs occur in intensive care units (ICU) [2] and 19% were related to SSI [3]
Discussion with physician reports included confirmed infections, colonization, or contamination; we considered that community infection is sometimes the source of outbreaks under certain circumstances, and the cross-spread of pathogens may cause infection, colonization or contamination in the hospital setting
Summary
We aimed to develop a real-time nosocomial infection surveillance system (RT-NISS) to monitor all nosocomial infections (NIs) and outbreaks in a Chinese comprehensive hospital to better prevent and control NIs. It is essential to establish real-time surveillance systems and to undertake corresponding control measurements, to significantly decrease NIs and prevent outbreaks. The prospective, targeted surveillance of surgical wounds has prevented and controlled NIs for many years [1]. The National Nosocomial Infections Surveillance system (NNIS) revealed that only 20% of NIs occur in intensive care units (ICU) [2] and 19% were related to SSI [3]. These data suggest that hospitalwide surveillance should be enforced to detect all NIs [4]
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