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Surveillance of nosocomial infections in ICUs: is postdischarge surveillance indispensable?
C Geffers1, P Gastmeier, H Bräuer
1Institute for Hygiene, Free University of Berlin, Germany.
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.
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