Comparison of effectiveness and required time of two surveillance methods in intensive care patients

Abstract

The intensive care unit (ICU) standardized protocol of the NNIS (National Nosocomial Infections Surveillance) system is a surveillance method of hospital acquired infections (HAI), which provides device-associated infection rates. The aim of this study was to assess the effectiveness and the required time for data collection and analysis of a selective surveillance method (SSM) derived from the NNIS ICU surveillance protocol, and to compare its data with that of a reference surveillance method (RSM). The sensitivity, specificity and the positive predictive value (PPV) of the RSM were 87.5, 100 and 100%, respectively. The sensitivity, specificity and the PPV of the SSM were 59.4 97.6 and 79.2%, respectively. Considering device-related infections only (ventilator-related pneumonia, catheter-related urinary tract infections, central line-related sepsis), the sensitivities of the RSM and the SSM were 80.9 and 90.5%, respectively. The SSM required only one third of the time of the RSM (1.1 h and 3.4 h per 10 beds per week with the SSM and the RSM, respectively). We conclude that the SSM has a very high sensitivity for detecting device associated infections, but is not sensitive enough for surveying all types of HAI.