Comparison of 2 Clostridium difficile Surveillance Methods: National Healthcare Safety Network's Laboratory-Identified Event Reporting Module versus Clinical Infection Surveillance
Comparison of 2 Clostridium difficile Surveillance Methods: National Healthcare Safety Network's Laboratory-Identified Event Reporting Module versus Clinical Infection Surveillance
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DOI：
10.1086/669509
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发表时间：
2013-03-01
影响因子：
4.5
通讯作者：
Stricof, Rachel L.
中科院分区：
文献类型：
--
作者：
Gase, Kathleen A.;Haley, Valerie B.;Stricof, Rachel L.
OBJECTIVE.通过比较2种监测方法，确定疾病控制和预防中心的国家医疗安全网络（NHSN）艰难梭菌感染（CDI）实验室识别（LabID）事件报告模块是否是临床CDI的适当替代指标，用于公共报告目的。验证研究.设置。30家纽约州立急症护理医院。30家机构使用临床感染监测定义收集了6个月的数据，同时还提交了NHSN LabID事件供CDI使用。对数据集进行匹配和比较，以确定分配的临床病例状态是否与LabID病例状态匹配。进一步评估了错配的子集，并量化了错配的原因。感染率确定使用2个定义进行了比较。共报告了3，301例CDI病例。原始数据分析得出67.3%（2，223/3，301）的总体病例状态匹配。经审查和验证，符合率为81.3%（2，683/3，301）。最常见的不同意原因（54.9%）是因为入院后不到48小时出现症状，但阳性标本是在住院第4天或之后收集的。NHSN LabID医院发病率比相应的临床发病率高29%，并且在所有医院中基本一致。使用NHSN LabID事件可最大限度地减少监督负担并简化流程。由于NHSN LabID事件数据与临床感染监测数据之间的匹配度超过80%，因此纽约州卫生部决定将NHSN LabID事件CDI数据用于公共报告目的。感染控制医院流行病学2013;34（3）：284-290
OBJECTIVE. To determine whether the Centers for Disease Control and Prevention's National Healthcare Safety Network (NHSN) laboratory-identified (LabID) event reporting module for Clostridium difficile infection (CDI) is an adequate proxy measure of clinical CDI for public reporting purposes by comparing the 2 surveillance methods.DESIGN. Validation study.SETTING. Thirty New York State acute care hospitals.METHODS. Six months of data were collected by 30 facilities using a clinical infection surveillance definition while also submitting the NHSN LabID event for CDI. The data sets were matched and compared to determine whether the assigned clinical case status matched the LabID case status. A subset of mismatches was evaluated further, and reasons for the mismatches were quantified. Infection rates determined using the 2 definitions were compared.RESULTS. A total of 3,301 CDI cases were reported. Analysis of the original data yielded a 67.3% (2,223/3,301) overall case status match. After review and validation, there was 81.3% (2,683/3,301) agreement. The most common reason for disagreement (54.9%) occurred because the symptom onset was less than 48 hours after admission but the positive specimen was collected on hospital day 4 or later. The NHSN LabID hospital onset rate was 29% higher than the corresponding clinical rate and was generally consistent across all hospitals.CONCLUSIONS. Use of the NHSN LabID event minimizes the burden of surveillance and standardizes the process. With a greater than 80% match between the NHSN LabID event data and the clinical infection surveillance data, the New York State Department of Health made the decision to use the NHSN LabID event CDI data for public reporting purposes. Infect Control Hosp Epidemiol 2013;34(3):284-290