Institute of Hygiene, Hospital Epidemiology and Environmental Health, University of Leipzig Medical Center, Liebigstraße 22, 04103, Leipzig, Germany.
Faculty of Medicine, Clinical Trial Centre (ZKS Leipzig), Leipzig University, Leipzig, Germany.
BMC Infect Dis. 2023 Mar 1;23(1):126. doi: 10.1186/s12879-023-08082-6.
The surveillance of hospital-acquired infections in Germany is usually conducted via manual chart review; this, however, proves resource intensive and is prone to a certain degree of subjectivity. Documentation based on electronic routine data may present an alternative to manual methods. We compared the data derived via manual chart review to that which was derived from electronic routine data.
Data used for the analyses was obtained from five of the University of Leipzig Medical Center's (ULMC) ICUs. Clinical data was collected according to the Protection against Infection Act (IfSG); documentation thereof was carried out in hospital information systems (HIS) as well as in the ICU-KISS module provided by the National Reference Center for the Surveillance of Nosocomial Infections (NRZ). Algorithmically derived data was generated via an algorithm developed in the EFFECT study; ward-movement data was linked with microbiological test results, generating a data set that allows for evaluation as to whether or not an infection was ICU-acquired.
Approximately 75% of MDRO cases and 85% of cases of sepsis/primary bacteremia were classified as ICU-acquired by both manual chart review and EFFECT. Most discrepancies between the manual and algorithmic approaches were due to differentiating definitions regarding the patients' time at risk for acquiring MDRO/bacteremia.
The concordance between manual chart review and algorithmically generated data was considerable. This study shows that hospital infection surveillance based on electronically generated routine data may be a worthwhile and sustainable alternative to manual chart review.
德国的医院获得性感染监测通常通过人工图表审查进行；然而，这证明是资源密集型的，并且容易受到一定程度的主观性影响。基于电子常规数据的文档记录可能是手动方法的替代方案。我们将通过手动图表审查获得的数据与通过电子常规数据获得的数据进行了比较。
用于分析的数据来自莱比锡大学医学中心（ULMC）的五个 ICU 之一。临床数据根据《感染保护法》（IfSG）收集；文档记录在医院信息系统（HIS）以及国家医院感染监测中心（NRZ）提供的 ICU-KISS 模块中完成。通过 EFFECT 研究中开发的算法生成算法衍生数据；病房移动数据与微生物测试结果相关联，生成一个数据集，可用于评估感染是否为 ICU 获得。
大约 75%的 MDRO 病例和 85%的败血症/原发性菌血症病例通过手动图表审查和 EFFECT 均被归类为 ICU 获得。手动和算法方法之间的大多数差异是由于对患者获得 MDRO/菌血症的风险时间的定义不同。
手动图表审查和算法生成的数据之间的一致性相当高。本研究表明，基于电子生成的常规数据的医院感染监测可能是手动图表审查的一种有价值且可持续的替代方案。
