Epidemiological findings of a single outbreak event may not be generalized; however, the characteristics of a typical outbreak can be determined on the basis of a large number of similar events. The Outbreak Database ( http://www.outbreak-database.com ) is the largest collection of nosocomial outbreaks currently available-and is still expanding. Articles are filed systematically, enabling those on a specific parameter of interest to be retrieved quickly. As such, this database is an extremely valuable tool on many medically related fronts, such as for educating other medical personnel, providing relevant information during the investigation of an acute outbreak, or addressing scientific-oriented questions. Several systematic reviews on a wide range of subjects, including sources of infections, types of pathogens, routes of transmission, appropriate infection control measures, and patients at risk of infection, have already been published based on information contained in this database. As this database may be used free of charge, all medical staff in the field of infection control, hygiene, and hospital epidemiology should be aware of its existence.
The authors' findings offer some support for recommendations to concentrate arthroscopy and knee replacement in surgical departments with more than 50 procedures and hip replacement in departments with more than 100 procedures per year in order to reduce SSI.
To develop a European surveillance protocol for Clostridium difficile infection (CDI), existing national CDI surveillance systems were assessed in 2011. A web-based electronic form was provided for all national coordinators of the European CDI Surveillance Network (ECDIS-Net). Of 35 national coordinators approached, 33 from 31 European countries replied. Surveillance of CDI was in place in 14 of the 31 countries, comprising 18 different nationwide systems. Three of 14 countries with CDI surveillance used public health notification of cases as the route of reporting, and in another three, reporting was limited to public health notification of cases of severe CDI. The CDI definitions published by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and the European Centre for Disease Prevention and Control (ECDC) were widely used, but there were differing definitions to distinguish between community- and healthcare-associated cases. All CDI surveillance systems except one reported annual national CDI rates (calculated as number of cases per patient-days). Only four surveillance systems regularly integrated microbiological data (typing and susceptibility testing results). Surveillance methods varied considerably between countries, which emphasises the need for a harmonised European protocol to allow consistent monitoring of the CDI epidemiology at European level. The results of this survey were used to develop a harmonised EU-wide hospital-based CDI surveillance protocol.
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