Validation of intensive care unit-acquired infection surveillance in the Italian SPIN-UTI network
Validation of intensive care unit-acquired infection surveillance in the Italian SPIN-UTI network
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DOI：
10.1016/j.jhin.2010.05.013
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发表时间：
2010-10-01
影响因子：
6.9
通讯作者：
Agodi, A.
中科院分区：
文献类型：
--
作者：
Masia, M. D.;Barchitta, M.;Agodi, A.
有效性是医院感染监测的关键因素之一。本文介绍了意大利重症监护病房（ICU）项目（SPIN-UTI）监测数据的首次验证研究。目的是验证感染数据，从而确定参与SPIN-UTI网络的ICU患者报告的NI数据的灵敏度、特异性以及阳性和阴性预测值。在监测期结束时进行了验证研究。由验证团队中经过培训的医生回顾性审查所有病历（包括所有临床和实验室数据），并计算阳性预测值（PPV）、阴性预测值（NPV）、灵敏度和特异性。从所有49个SPIN-UTI ICU中随机选择8个ICU（16.3%）进行验证研究。确认团队共审查了832例患者病历（占SPIN-UTI患者的27.3%）。PPV为83.5%，NPV为97.3%。总体敏感性为82.3%，总体特异性为97.2%。NI的过度报告和报告不足与病例定义的误解和方案偏离有关，尽管之前进行了培训和指导。本研究的结果是有用的，以确定方法学问题的监测系统内，并已被用来规划监测人员的再培训，并设计和实施的SPIN-UTI项目的第二阶段。(C)2010年，医院感染协会。由爱思唯尔有限公司出版。保留所有权利。
Validity is one of the most critical factors concerning surveillance of nosocomial infections (NIs). This article describes the first validation study of the Italian Nosocomial Infections Surveillance in Intensive Care Units (ICUs) project (SPIN-UTI) surveillance data. The objective was to validate infection data and thus to determine the sensitivity, specificity, and positive and negative predictive values of NI data reported on patients in the ICUs participating in the SPIN-UTI network. A validation study was performed at the end of the surveillance period. All medical records including all clinical and laboratory data were reviewed retrospectively by the trained physicians of the validation team and a positive predictive value (PPV), a negative predictive value (NPV), sensitivity and specificity were calculated. Eight ICUs (16.3%) were randomly chosen from all 49 SPIN-UTI ICUs for the validation study. In total, the validation team reviewed 832 patient charts (27.3% of the SPIN-UTI patients). The PPV was 83.5% and the NPV was 97.3%. The overall sensitivity was 82.3% and overall specificity was 97.2%. Over-and under-reporting of NIs were related to misinterpretation of the case definitions and deviations from the protocol despite previous training and instructions. The results of this study are useful to identify methodological problems within a surveillance system and have been used to plan retraining for surveillance personnel and to design and implement the second phase of the SPIN-UTI project. (C) 2010 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.