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RESEARCH ARTICLE

Epidemiology of healthcare-associated infections: uses, pitfalls and the future

Mary-Louise McLaws
+ Author Affiliations
- Author Affiliations

School of Public Health and Community Medicine
The University of New South Wales
Sydney, NSW 2052, Australia
Tel: +61 2 9385 2586
Fax: +61 2 93136185
Email: m.mclaws@unsw.edu.au

Microbiology Australia 35(1) 17-23 https://doi.org/10.1071/MA14006
Published: 10 February 2014

Abstract

This paper provides an overview of the history of epidemiological activities in Australia at state and national levels to monitor healthcare-associated infections (HAIs), an examination of the pitfalls of surveillance as an epidemiological design for causality of HAIs and the attempts at correcting them, the ease of web access for information about statewide programs and reports and a look into the future of HAI epidemiology.


References

[1]  Rountree, P.M. and Thomas, E.F. (1949) Incidence of penicillin-resistant and streptomycin-resistant Staphylococci in a hospital. Lancet 254, 501–504.
Incidence of penicillin-resistant and streptomycin-resistant Staphylococci in a hospital.Crossref | GoogleScholarGoogle Scholar |

[2]  Turnidge, J.D. et al. (1996) Evolution of resistance in Staphylococcus aureus in Australian teaching hospitals. Australian Group on Antimicrobial Resistance (AGAR). Med. J. Aust. 164, 68–71.
| 1:STN:280:DyaK287lvVyitA%3D%3D&md5=38600d0497cdd3d4a40a2433e23136aaCAS | 8569574PubMed |

[3]  Riley, T.V. et al. (1983) Diarrhoea associated with Clostridium difficile in a hospital population. Med. J. Aust. 1, 166–169.
| 1:STN:280:DyaL3s7ptFyhtw%3D%3D&md5=f50b3ded15902aff5552c35dbacb183eCAS | 6843465PubMed |

[4]  McLaws, M.L. et al. (1988) The prevalence of nosocomial and community acquired infections in Australian Hospitals. Med. J. Aust. 149, 582–590.
| 1:STN:280:DyaL1M%2FntVemuw%3D%3D&md5=0bf568ce8cd5d994ec9fd555897ad035CAS | 3143900PubMed |

[5]  McLaws, M.L. and Taylor, P. (2003) The Hospital Infection Standardised Surveillance (HISS) programme: analysis of a two-year pilot. J. Hosp. Infect. 53, 259–267.
The Hospital Infection Standardised Surveillance (HISS) programme: analysis of a two-year pilot.Crossref | GoogleScholarGoogle Scholar | 12660122PubMed |

[6]  Queensland Health. Centre for Healthcare Related Infection Surveillance and Prevention and Tuberculosis Control. http://www.health.qld.gov.au/chrisp/ (accessed 12 November 2013).

[7]  Russo, P.L. et al. (2006) The establishment of a statewide surveillance program for hospital-acquired infections in large Victorian public hospitals: a report from the VICNISS Coordinating Centre. Infect. Control Hosp. Epidemiol. 34, 430–436.

[8]  Western Australia Department of Health. Public health. http://www.public.health.wa.gov.au/3/455/2/reports_healthcare_associated_infection_unit.pm (accessed 12 November 2013).

[9]  South Australia Health. http://www.health.sa.gov.au/INFECTIONCONTROL/Default.aspx?tabid=147 (accessed 12 November 2013).

[10]  Australian Commission for Quality and Safety in Healthcare. http://www.safetyandquality.gov.au (accessed 12 November 2013).

[11]  McBryde, E.S. et al. (2009) Validation of Statewide Surveillance System Data on Central Line-Associated Bloodstream Infection in Intensive Care Units in Australia. Infect. Control Hosp. Epidemiol. 30, 1045–1049.
Validation of Statewide Surveillance System Data on Central Line-Associated Bloodstream Infection in Intensive Care Units in Australia.Crossref | GoogleScholarGoogle Scholar | 19803720PubMed |

[12]  Rotham, K.J. et al. (2008) Modern Epidemiology (Third edn). Wolters Kluwer Lippincott Williams and Wilkins, Philadelphia.

[13]  NHMRC (2009) NHMRC additional levels of evidence and grades for recommendations for developers of guidelines. National Health and Medical Research Council, Canberra. http://www.nhmrc.gov.au/.../stage_2_consultation_levels_and_grades.pdf (accessed 12 November 2013).

[14]  Culver, D.H. et al. (1991) Surgical wound infection rates by wound class, operative procedure, and patient risk index. Am. J. Med. 91, S152–S157.
Surgical wound infection rates by wound class, operative procedure, and patient risk index.Crossref | GoogleScholarGoogle Scholar |

[15]  Friedman, N.D. et al. (2007) Performance of the national nosocomial infections surveillance risk index in predicting surgical site infection in Australia. Infect. Control Hosp. Epidemiol. 28, 55–59.
Performance of the national nosocomial infections surveillance risk index in predicting surgical site infection in Australia.Crossref | GoogleScholarGoogle Scholar | 17230388PubMed |

[16]  Clements, A.C.A. et al. (2007) Risk stratification for surgical site infections in Australia: evaluation of the NNIS risk index. J. Hosp. Infect. 66, 148–155.
Risk stratification for surgical site infections in Australia: evaluation of the NNIS risk index.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2szjsVKltA%3D%3D&md5=5600bbc82de8cd7a766dda6b74049b69CAS |

[17]  Morton, A.P. et al. (2008) Surveillance of healthcare-acquired infections in Queensland, Australia: data and lessons from the first 5 years. Infect. Control Hosp. Epidemiol. 29, 695–701.
Surveillance of healthcare-acquired infections in Queensland, Australia: data and lessons from the first 5 years.Crossref | GoogleScholarGoogle Scholar | 18690786PubMed |

[18]  Centers for Disease Control and Prevention. NHSN newsletter – your guide to the standardized infection ratio. http://www.cdc.gov/nhsn/PDFs/Newsletters/NHSN_NL_OCT_2010SE_final.pdf (accessed 10 November 2013).

[19]  McLaws, M.L. and Burrell, A. (2012) Zero-risk for central line associated bloodstream infection: are we there yet? Crit. Care Med. 40, 388–393.
Zero-risk for central line associated bloodstream infection: are we there yet?Crossref | GoogleScholarGoogle Scholar | 22020239PubMed |

[20]  Worth, L.J. and McLaws, M.L. (2012) Is it possible to achieve a target of zero central line associated bloodstream infections? Curr. Opin. Infect. Dis. 25, 650–657.
Is it possible to achieve a target of zero central line associated bloodstream infections?Crossref | GoogleScholarGoogle Scholar | 23041775PubMed |

[21]  Gelman, A. and Hill, J. (2007) Data Analysis Using Regression and Multilevel/Hierarchical Models. Cambridge University Press, Melbourne.

[22]  Morton, A.P. et al. (2001) The application of statistical process control charts to the detection and monitoring of hospital-acquired infections. J. Qual. Clin. Pract. 21, 112–117.
The application of statistical process control charts to the detection and monitoring of hospital-acquired infections.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD387ivF2gsA%3D%3D&md5=7e78af81defe2e379dfbc334b731cee3CAS | 11856406PubMed |

[23]  Morton, A.P. et al. (2008) Surveillance of healthcare-acquired infections in Queensland, Australia: data and lessons from the first 5 years. Infect. Control Hosp. Epidemiol. 29, 695–701.
Surveillance of healthcare-acquired infections in Queensland, Australia: data and lessons from the first 5 years.Crossref | GoogleScholarGoogle Scholar | 18690786PubMed |

[24]  Saint, S. et al. (2009) Translating health care–associated urinary tract infection prevention research into practice via the bladder bundle. Jt. Comm. J. Qual. Patient Saf. 35, 449–455.
| 19769204PubMed |

[25]  Wip, C. and Napolitano, L. (2009) Bundles to prevent ventilator-associated pneumonia: how valuable are they? Curr. Opin. Infect. Dis. 22, 159–166.
Bundles to prevent ventilator-associated pneumonia: how valuable are they? Crossref | GoogleScholarGoogle Scholar | 19276975PubMed |

[26]  Playford, G.E. et al. (2012) Problematic linkage of publicly disclosed hand hygiene compliance and health care-associated Staphylococcus aureus bacteraemia rates. Med. J. Aust. 197, 29–30.
Problematic linkage of publicly disclosed hand hygiene compliance and health care-associated Staphylococcus aureus bacteraemia rates.Crossref | GoogleScholarGoogle Scholar |

[27]  Worth, L.J. et al. (2013) Public reporting of health care-associated infection data in Australia: time to refine. Med. J. Aust. 198, 252–253.
Public reporting of health care-associated infection data in Australia: time to refine.Crossref | GoogleScholarGoogle Scholar | 23496389PubMed |