European perspective on surveillance.

International comparisons yield interesting insights regarding quality of care, beyond the field of healthcare-associated infection (HAI) prevention. Therefore, the exchange of experiences of national surveillance systems should be encouraged. However, the interpretation of differences of HAI rates should be made very carefully. Differences in healthcare systems, legal and cultural aspects, as well as differences in the methods of the surveillance systems, may have an enormous influence. One of the most crucial aspects of surveillance data is their validity, therefore it would be very helpful to combine the experience of all European validation studies performed in order to develop a protocol for a meaningful and cost-effective method for performing validation studies. Meanwhile some national surveillance systems have shown their effectiveness with reductions of 24 57% for surgical site infections (SSIs) and 20 29% for HAI in ICUs. Today, mandatory public reporting is probably the most demanding problem for the national HAI surveillance systems in Europe. The exchange of experience between the European surveillance networks in this respect in particular--remains a cornerstone and will motivate further activities in the individual countries.