Title : Surveillance of healthcare-associated infections: New challenges for the next decade
Abstract:
Healthcare-associated infections (HAI) are one of the most frequent adverse events in hospitalized patients. Their potential outcomes could be fatal or severe and represent a significant disease burden. In addition, a part of HAI is due to multidrug-resistant organisms (MDRO), which extension represents a threat for both the hospital and the community. For the last three decades, most HAI and AMR pathogens are targeted by infection control (IC) programs in many countries including European countries.
Since surveillance is historically the trigger for launching IC programs, the World Health Organization (WHO) has reminded recently that an HAI surveillance system is crucial for both national and hospital IC programs, being one of the eight core components defined for effective HAI control (Storr J, Antimicrob Resist Infect Control 2017, 6:6). The surveillance systems which are rolled varies according to the HAI targeted (surgical-site infections (SSI), bloodstream infections, ventilator-assisted pneumonia, antimicrobial resistant pathogens (AMR)), patient groups and allocated resources. However, they are all fostered to develop feedback and automation using information technology (IT). Surveillance systems are aimed to provide evidenced-based information for acting and orienting prevention. Therefore, the feedback of surveillance data to caregivers and policymakers is a key issue to decrease HAI and AMR incidence rates.
For decades, many surveillance networks at the national level have demonstrated that participation can truly contribute to a reduction of HAI or AMR rates (Abbas M, J Hosp Infect, 2019, 102:267e76). However, to get stakeholders’ adhesion to a surveillance program presupposes the existence of a simple, effective, and reactive system. The main issue is then to develop a user-friendly system for caregivers, which will not be too time-consuming, but also informative for decision makers, and yet, not too costly in terms of human and financial resources.
To date, different countries propose pilots of automated surveillance systems based on the methods of the PRAISE European initiative (Providing a roadmap for automated infection surveillance in Europe) (Van Mourik MSM, Doi: 10.1016/j.cmi.2021.02.028). In this context, France has launched at the national level different automated surveillance systems focus primarily on SSI and AMR. Overall, the future development of automated HAI surveillance systems depends primarily on the ability of the hospitals to get their own resources and expertise in IT, but also on the awareness of healthcare staff to be involved in infection control.
