Reproducibility of the surveillance effect to decrease nosocomial infection rates

Area of Science:

• Healthcare epidemiology
• Infection control and prevention
• Public health surveillance

Background:

• Nosocomial infections, including central venous catheter (CVC)-associated bloodstream infections (BSI), ventilator-associated pneumonia (VAP), and surgical site infections (SSI), pose significant risks in healthcare settings.
• Surveillance systems are crucial for monitoring and reducing these infections, but their long-term reproducibility and independence from temporal confounding factors require investigation.

Purpose of the Study:

• To assess the reproducibility of infection reduction effects from a national nosocomial infection surveillance system.
• To determine if the observed reductions in CVC-associated BSI, VAP, and SSI are independent of specific time periods and potential confounding factors.

Main Methods:

• Analysis of German national nosocomial infection surveillance system data from January 1997 to June 2008.
• Calculation of monthly infection rates for 36 months following different starting periods for CVC-associated BSI, VAP, and SSI.
• Comparison of infection rates between the first and third surveillance years using relative risks to evaluate the surveillance effect.

Main Results:

• A significant reduction in VAP was observed across investigated periods (overall RR, 0.80).
• Significant reductions in CVC-associated BSI were found in 2 of 3 periods (overall RR, 0.83).
• Significant reductions in SSI were noted for knee prosthesis insertion (2 periods) and cesarean delivery (3 periods), but not for endoscopically performed cholecystectomy.

Conclusions:

• The surveillance effect, characterized by reduced nosocomial infection rates, is consistently observed.
• This reduction is evident between the first and third years of participation in the surveillance system.
• The positive impact of the surveillance system on infection rates is reproducible and independent of the calendar year of implementation.