Surveillance of nosocomial infection: extension, organisation and methods in European countries and regions

Abstract number: 1134_04_230

Fabry J., Russell I., Savey A., Suetens C.

In the context of European harmonisation of communicable diseases surveillance, EU countries and Norway were surveyed to assess the status of surveillance of nosocomial infections (NI) nationally and/or regionally. The questionnaire was completed by the network's coordinators. Twenty-six networks were created in 17 countries (or regions) between 1992 and 2003, and were still functioning in September 2004. Six countries targeted Surgical Site Infections (SSI) only, one infections in ICU patients only and ten in both. Nineteen networks in 14 countries use a HELICS-compatible protocol and already contribute to the HELICS European database. Other countries or regions are initiating incidence or prevalence pilot surveys, with the objective of implementing a stable HELICS-associated network. Usually a national Public Health Institute runs the programme, sometimes in connection with other bodies. Around 2000 European hospitals participate (usually voluntarily) in a structured surveillance network, yielding an estimated coverage of 30%. Half of them receive funding from their Ministry of Health, with 8 receiving additional funding from a health agency, hospital organisation or from hospitals themselves. The funding covers expenses of information technology and variable levels of coordination staff in the networks. Except in Germany, the data collection in ICU networks is patient-based. Only 6 out of 16 SSI networks organise post-discharge surveillance (PDS). Surveillance is continuous in a few cases, with others being discontinuous. Data is entered locally in all networks, except in 4 where it is entered at the coordinating centre. Control of data quality is always performed but with different means and scope. Surveillance of NI is expanding in Europe and the HELICS programme has allowed the progressive harmonisation of data. However, persisting discrepancies should be addressed: (1) resources required for coordination and data collection should be defined more precisely, (2) the need for training materials and exchange of experience between networks, (3) collaborative, multi-centre research should address the unresolved problems of PDS and (4) monitoring of the validity of data.