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医疗保健相关感染的自动监测系统:一项欧洲调查的结果及实际应用经验

Automated surveillance systems for healthcare-associated infections: results from a European survey and experiences from real-life utilization.

作者信息

Verberk J D M, Aghdassi S J S, Abbas M, Nauclér P, Gubbels S, Maldonado N, Palacios-Baena Z R, Johansson A F, Gastmeier P, Behnke M, van Rooden S M, van Mourik M S M

机构信息

Department of Medical Microbiology and Infection Prevention, University Medical Centre Utrecht, Utrecht, the Netherlands; Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands; Department of Epidemiology and Surveillance, Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.

Institute of Hygiene and Environmental Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Berlin Institute of Health at Charité-Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Digital Clinician Scientist Program, Charitéplatz 1,10117 Berlin, Germany.

出版信息

J Hosp Infect. 2022 Apr;122:35-43. doi: 10.1016/j.jhin.2021.12.021. Epub 2022 Jan 12.

Abstract

BACKGROUND

As most automated surveillance (AS) methods to detect healthcare-associated infections (HAIs) have been developed and implemented in research settings, information about the feasibility of large-scale implementation is scarce.

AIM

To describe key aspects of the design of AS systems and implementation in European institutions and hospitals.

METHODS

An online survey was distributed via e-mail in February/March 2019 among (i) PRAISE (Providing a Roadmap for Automated Infection Surveillance in Europe) network members; (ii) corresponding authors of peer-reviewed European publications on existing AS systems; and (iii) the mailing list of national infection prevention and control focal points of the European Centre for Disease Prevention and Control. Three AS systems from the survey were selected, based on quintessential features, for in-depth review focusing on implementation in practice.

FINDINGS

Through the survey and the review of three selected AS systems, notable differences regarding the methods, algorithms, data sources, and targeted HAIs were identified. The majority of AS systems used a classification algorithm for semi-automated surveillance and targeted HAIs were mostly surgical site infections, urinary tract infections, sepsis, or other bloodstream infections. AS systems yielded a reduction of workload for hospital staff. Principal barriers of implementation were strict data security regulations as well as creating and maintaining an information technology infrastructure.

CONCLUSION

AS in Europe is characterized by heterogeneity in methods and surveillance targets. To allow for comparisons and encourage homogenization, future publications on AS systems should provide detailed information on source data, methods, and the state of implementation.

摘要

背景

由于大多数用于检测医疗保健相关感染(HAIs)的自动化监测(AS)方法是在研究环境中开发和实施的,关于大规模实施可行性的信息很少。

目的

描述欧洲机构和医院中AS系统设计和实施的关键方面。

方法

2019年2月/3月通过电子邮件向以下人员分发了在线调查问卷:(i)PRAISE(为欧洲自动化感染监测提供路线图)网络成员;(ii)关于现有AS系统的欧洲同行评审出版物的通讯作者;(iii)欧洲疾病预防控制中心国家感染预防与控制联络点的邮件列表。根据典型特征从调查中选择了三个AS系统,进行深入审查,重点关注实际实施情况。

结果

通过调查和对三个选定AS系统的审查,确定了在方法、算法、数据源和目标HAIs方面的显著差异。大多数AS系统使用分类算法进行半自动监测,目标HAIs主要是手术部位感染、尿路感染、败血症或其他血流感染。AS系统减少了医院工作人员的工作量。实施的主要障碍是严格的数据安全法规以及创建和维护信息技术基础设施。

结论

欧洲的AS在方法和监测目标方面具有异质性。为了便于比较并鼓励同质化,未来关于AS系统的出版物应提供有关源数据、方法和实施状态的详细信息。

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