Building benchmark through active surveillance : the Italian network SPIN-UTI

Objectives: The Italian Nosocomial Infections Surveillance in Intensive Care Units (ICUs) (SPIN-UTI) project of the Italian Study Group of Hospital Hygiene (GISIO) – Italian Society of Hygiene, Preventive Medicine and Public Health (SItI), was implemented to ensure standardisation of definitions, data collection and reporting procedures coherently with the HELICS-ICU benchmark. Methods: Hospitals were invited to join the SPIN-UTI project by GISIO members. Before starting surveillance, participant ICUs were gathered in order to involve the key stakeholders in the project through participated planning. A first phase consisted in a training session to share and further refine the protocol and the data collection tools. Four electronic data forms, designed using SPSS Data Entry Enterprise Server (SPSS Inc.) for web-based data collection, were presented and discussed. After a monitoring phase, the final SPIN-UTI protocol and tools were produced integrating as much as possible the conclusions of debates and discussions and the analysis of the methods used in the existing national surveillance protocols. The six-months patient-based prospective survey was performed from November 2006 to May 2007, preceded by a one-month surveillance pilot study to assess the overall feasibility of the programme, and to determine the needed time and resources for participant hospitals. Results: The SPIN-UTI project included 53 ICUs, 3,046 patients with length of stay longer than two days and 35,152 patient-days. A total of 619 infections were reported accounting for an incidence rate of 20.3 per 100 patients and an incidence density of 17.6 per 1000 patient-days. The most frequently encountered infection site was pneumonia and “Pseudomonas aeruginosa” the most frequent infection-associated microorganism, followed by “Staphylococcus aureus” and “Acinetobacter baumannii”. Site-specific infection rates, for pneumonia, bloodstream infections, central venous catheter-related bloodstream infections and urinary tract infections, stratified according to patient risk factors, were below the 75th percentile reported by the HELICS network benchmark. Conclusion: The SPIN-UTI project showed that introduction of ongoing surveillance does seem to be possible in many Italian hospitals. The study provided the opportunity to participate in the HELICS project using benchmark data for comparison and for better understanding of factors that impact on associated risks. Session Info: Nosocomial infections and infection control Session Type: Oral presentations