Concordance between European and US case definitions of healthcare-associated infections.
Concordance between European and US case definitions of healthcare-associated infections.
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DOI：
10.1186/2047-2994-1-28
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发表时间：
2012-08-02
影响因子：
5.5
通讯作者：
Gastmeier P
中科院分区：
文献类型：
--
作者：
Hansen S;Sohr D;Geffers C;Astagneau P;Blacky A;Koller W;Morales I;Moro ML;Palomar M;Szilagyi E;Suetens C;Gastmeier P
监测医疗保健相关感染(HAI)是降低感染率的一项有价值的措施。在整个欧洲，对HAI比率的国家间比较似乎有限，因为一些国家使用美国疾病控制和预防中心(CDC/NHSN)的定义，而其他国家使用欧洲医院通过监测进行感染控制链接(HELICS/IPSE)项目的欧洲定义。在这项研究中，我们分析了美国和欧洲对HAI的定义的一致性。一个由来自七个欧洲国家的专家组成的国际工作组成立，以确定美国和欧洲定义之间的差异，然后在三个月的时间内(2010年3月1日至5月31日)使用这两套定义进行监测。病例定义之间的一致性用Cohen‘s kappa统计量(κ)进行评估。血液感染(BSI)、肺炎(PN)、尿路感染(UTI)以及“重症监护病房(ICU)-获得性感染”和“机械呼吸”这两个关键术语的HAI定义存在差异。对这些定义和关键术语(UTI除外)进行了一致性分析。对47个ICU进行了监测，对6506名患者进行了评估。共查出PN 180例，BSI 123例。当考虑所有的PN病例时，PN的符合率为κ = 0.99[CI 95%：0.98~1.00]。当将PN病例分为亚组时，临床定义的PN与微生物定义的PN的符合率分别为κ = 0.90(CI 95%：0.86~0.94)和κ = 0.72(CI 95%：0.63~0.82)。BSI的一致性为κ = 0.73[可信区间95%：0.66~0.80]。然而，当使用US定义时，继发于其他感染部位的血型感染病例(占所有血型感染病例的42%)被排除，当仅考虑原发血型感染病例时，血型感染的一致性为κ = 1.00，即欧洲定义的来源“导管”或“未知”来源的血型感染和美国定义的实验室确认的血型感染(LCBI)。我们的研究表明，美国和欧洲对PN和BSI的定义具有很好的一致性。如果考虑到这项研究中强调的几点，使用美国或欧洲定义的国家的PN和初级BSI比率可以进行比较。
Surveillance of healthcare-associated infections (HAI) is a valuable measure to decrease infection rates. Across Europe, inter-country comparisons of HAI rates seem limited because some countries use US definitions from the US Centers for Disease Control and Prevention (CDC/NHSN) while other countries use European definitions from the Hospitals in Europe Link for Infection Control through Surveillance (HELICS/IPSE) project. In this study, we analyzed the concordance between US and European definitions of HAI. An international working group of experts from seven European countries was set up to identify differences between US and European definitions and then conduct surveillance using both sets of definitions during a three-month period (March 1st -May 31st, 2010). Concordance between case definitions was estimated with Cohen’s kappa statistic (κ). Differences in HAI definitions were found for bloodstream infection (BSI), pneumonia (PN), urinary tract infection (UTI) and the two key terms “intensive care unit (ICU)-acquired infection” and “mechanical ventilation”. Concordance was analyzed for these definitions and key terms with the exception of UTI. Surveillance was performed in 47 ICUs and 6,506 patients were assessed. One hundred and eighty PN and 123 BSI cases were identified. When all PN cases were considered, concordance for PN was κ = 0.99 [CI 95%: 0.98-1.00]. When PN cases were divided into subgroups, concordance was κ = 0.90 (CI 95%: 0.86-0.94) for clinically defined PN and κ = 0.72 (CI 95%: 0.63-0.82) for microbiologically defined PN. Concordance for BSI was κ = 0.73 [CI 95%: 0.66-0.80]. However, BSI cases secondary to another infection site (42% of all BSI cases) are excluded when using US definitions and concordance for BSI was κ = 1.00 when only primary BSI cases, i.e. Europe-defined BSI with ”catheter” or “unknown” origin and US-defined laboratory-confirmed BSI (LCBI), were considered. Our study showed an excellent concordance between US and European definitions of PN and primary BSI. PN and primary BSI rates of countries using either US or European definitions can be compared if the points highlighted in this study are taken into account.
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影响因子：
11.8
作者：
Gaynes, R;Richards, C;Tolson, J
通讯作者：
Tolson, J
影响因子：
6.9
作者：
Gastmeier, P.;Hentschel, J.;Rueden, H.
通讯作者：
Rueden, H.
影响因子：
4.9
作者：
Horan, Teresa C.;Andrus, Mary;Dudeck, Margaret A.
通讯作者：
Dudeck, Margaret A.
影响因子：
5
作者：
HALEY, RW;CULVER, DH;HOOTON, TM
通讯作者：
HOOTON, TM
影响因子：
--
作者：
Wilson, APR;Gibbons, C;Pearson, A
通讯作者：
Pearson, A