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Advances in electronic surveillance for healthcare-associated infections in the 21st Century: a systematic review

  • R. Freeman
    Correspondence
    Corresponding author. Address: Centre for Infection Prevention and Management, Division of Infectious Disease and Immunity, Department of Medicine, 8th Floor, Commonwealth Building, Imperial College London, Du Cane Road, London W12 0NN, UK. Tel.: +44 (0) 20 8327 6287; fax: +44 (0) 20 8200 7868.
    Affiliations
    National Centre for Infection Prevention and Management, Imperial College, London, UK
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  • L.S.P. Moore
    Affiliations
    National Centre for Infection Prevention and Management, Imperial College, London, UK

    Department of Infectious Diseases, Imperial College Healthcare NHS Trust, London, UK
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  • L. García Álvarez
    Affiliations
    National Centre for Infection Prevention and Management, Imperial College, London, UK
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  • A. Charlett
    Affiliations
    Statistics, Modelling and Economics Department, Health Protection Agency, London, UK
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  • A. Holmes
    Affiliations
    National Centre for Infection Prevention and Management, Imperial College, London, UK

    Infection Prevention and Control, Imperial College Healthcare NHS Trust, London, UK
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      Summary

      Background

      Traditional methodologies for healthcare-associated infection (HCAI) surveillance can be resource intensive and time consuming. As a consequence, surveillance is often limited to specific organisms or conditions. Various electronic databases exist within the healthcare setting and may be utilized to perform HCAI surveillance.

      Aim

      To assess the utility of electronic surveillance systems for monitoring and detecting HCAI.

      Methods

      A systematic review of published literature on surveillance of HCAI was performed. Databases were searched for studies published between January 2000 and December 2011. Search terms were divided into infection, surveillance and data management terms, and combined using Boolean operators. Studies were included for review if they demonstrated or proposed the use of electronic systems for HCAI surveillance.

      Findings

      In total, 44 studies met the inclusion criteria. For the majority of studies, emphasis was on the linkage of electronic databases to provide automated methods for monitoring infections in specific clinical settings. Twenty-one studies assessed the performance of their method with traditional surveillance methodologies or a manual reference method. Where sensitivity and specificity were calculated, these varied depending on the organism or condition being surveyed and the data sources employed.

      Conclusions

      The implementation of electronic surveillance was found to be feasible in many settings, with several systems fully integrated into hospital information systems and routine surveillance practices. The results of this review suggest that electronic surveillance systems should be developed to maximize the efficacy of abundant electronic data sources existing within hospitals.

      Keywords

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