Validation of Surveillance in the Intensive Care Unit Component of the German Nosocomial Infections Surveillance System

Abstract

A validation study was performed for the intensive care unit component of the German nosocomial infections surveillance system (Krankenhaus Infektions Surveillance System [KISS]). A total of 286 reported infections and 1,195 medical records with no reported infection from 20 randomly selected KISS intensive care units were reviewed by trained physicians. The mean sensitivity was 66% (median, 81%), and the mean specificity was 99.4% (median, 99.6%).

A pilot validation in 10 European Union Member States of a point prevalence survey of healthcare-associated infections and antimicrobial use in acute hospitals in Europe, 2011

“…In our study, agreement between the validation and the primary data collectors on more basic demographic variables ranged from moderate for the McCabe score to very good for sex and age. This finding was in line with the scarce literature published to date [11][12][15][16][17][18][19], wherein basic demographic variables such as age and sex tend to have very good levels of agreement compared to those variables where interpretation is required, such as the McCabe score or other markers of co-morbidity. The variables requiring abstractor judgment in this pilot validation study usually involved verification with a clinician present on the ward, which may account for the higher than expected validity.…”

Case vignettes to evaluate the accuracy of identifying healthcare-associated infections by surveillance persons

“…Our results confirm earlier data showing that SPs with higher levels of education, those with an external status and with more surveillance experience have a significantly higher diagnostic accuracy. 9 Our findings have some limitations. First, our validation methods concentrate on the confirmation phase of diagnosing HCAI, but the sensitivity of identifying HCAI is also related to the quality of recognizing signs and symptoms of HCAI during routine surveillance.…”

“…Larson et al demonstrated their usefulness more than 20 years ago and other colleagues have also used them effectively. 1,5,6,9 However, to our knowledge this is the first study evaluating the association of the sensitivity of diagnosing case vignettes with HCAI rates in units participating in a national surveillance system.…”

Effectiveness of a nationwide nosocomial infection surveillance system for reducing nosocomial infections

“…However, data were used from the validation study of the ICU component of KISS to investigate whether a particular year or duration of participation in KISS were possible risk factors for insufficient sensitivity in identifying NI. 19 Thirdly, it is likely that surveillance stimulates further infection control measures, not only by giving initial feedback of surveillance data but also by routine activities and the presence of surveillance personnel on the wards. It is possible that there were particular targeted interventions during the period of study, but only limited and inconclusive data are available from a small number of hospitals to assess this.…”