Efficacy of different surveillance systems in detecting hospital-acquired infections

Microbiology laboratory reports are the principal data source for nosocomial infection surveillance in most European countries. Such laboratory based surveillance inherently lacks sensitivity so that additional sources of data are necessary to increase the detection of infections. Long term compliance of voluntary reporting by clinical or ward nursing staff has rarely been achieved but continuous and selective clinical surveillance has been implemented successfully in the USA. Selective clinical surveillance, supplemented by laboratory data, may be a practical proposition in Europe, even with existing staffing levels and validation studies of the various methods are needed urgently.