Researchers Analyze the Concordance Between U.S. and European Definitions of HAIs

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 U.S. definitions from the Centers for Disease Control and Prevention (CDC) while other countries use European definitions from the Hospitals in Europe Link for Infection Control through Surveillance (HELICS/IPSE) project. Hansen, et al. (2012) analyzed the concordance between U.S. and European definitions of HAI.
 
An international working group of experts from seven European countries was set up to identify differences between U.S. and European definitions and then conduct surveillance using both sets of definitions during a three-month period (March 1 through May 31, 2010). Concordance between case definitions was estimated with Cohen's kappa statistic.
 
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.

The researchers say their study showed an excellent concordance between U.S. and European definitions of PN and primary BSI. PN and primary BSI rates of countries using either U.S. or European definitions can be compared if the points highlighted in this study are taken into account. Their research was published in Antimicrobial Resistance and Infection Control.

Reference: Hansen S, Sohr D, et al. Concordance between European and US case definitions of healthcare-associated infections. Antimicrobial Resistance and Infection Control 2012, 1:28 doi:10.1186/2047-2994-1-28