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Surveillance of Nosocomial Infections in Icus: Is Postdischarge Surveillance Indispensable?

Published online by Cambridge University Press:  02 January 2015

Christine Geffers*
Affiliation:
Institute for Hygiene, Free University of Berlin, Germany German National Reference Center for Hospital Hygiene, Berlin, Germany
Petra Gastmeier
Affiliation:
Institute for Hygiene, Free University of Berlin, Germany German National Reference Center for Hospital Hygiene, Berlin, Germany
Helga Bräuer
Affiliation:
Institute for Hygiene, Free University of Berlin, Germany German National Reference Center for Hospital Hygiene, Berlin, Germany
Franz Daschner
Affiliation:
Institute for Environmental Medicine and Hospital Hygiene, Albert-Ludwigs-University at Freiburg, Germany German National Reference Center for Hospital Hygiene, Berlin, Germany
Henning Rüden
Affiliation:
Institute for Hygiene, Free University of Berlin, Germany German National Reference Center for Hospital Hygiene, Berlin, Germany
*
Zentralbereich Krankenhaushygiene, Charitè, Heubnerweg 6 (Haus II), 14059 Berlin, Germany

Abstract

Objective:

To determine how many infections are missed if the postdischarge surveillance (PDS) follow-up of intensive care unit (ICU) patients that is required by the National Nosocomial Infection Surveillance System method is not done.

Design:

ICU patients were followed up and surveillance results with PDS (gold standard) and without PDS were compared.

Setting:

Surgical or interdisciplinary ICUs in eight German acute-care hospitals.

Patients:

All 1,857 patients within a 6-month period in the participating ICUs (a total of 9,129 ICU-patient–days).

Results:

Without PDS, 45 urinary tract infections (UTIs) were diagnosed, compared with 53 with PDS; thus, 15% of the UTIs were missed if no postdischarge follow-up was performed. Three nosocomial pneumonias (4%) and one bloodstream infection (8%) also were missed if surveillance was carried out without PDS. A total of 198 nosocomial infections (NIs) were recorded with PDS, compared to 175 NIs without PDS. Approximately 12% of all ICU-associated NIs were missed if no follow-up was done.

Conclusions:

Since it is very time-consuming to follow patients after their transfer from the ICU, we do not perform a postdischarge follow-up of patients in the course of routine surveillance.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2001

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