European surveillance of healthcare-associated infections in intensive care units : HAI-Net ICU protocol, version 1.02

European surveillance of healthcare-associated infections in intensive care unitThe Council Recommendation of 9 June 2009 on patient safety (2009/C 151/01), which also addresses the prevention and control of healthcare-associated infections (HAI), recommends ‘performing the surveillance of the incidence of targeted infection types’, ‘using surveillance methods and indicators as recommended by ECDC and case definitions as agreed upon at Community level in accordance with the provisions of Decision No 2119/98/EC’ 1,2. In 2000–2002, harmonised methods for the surveillance of two targeted infection types, surgical site infections (SSI) and healthcare-associated infections in intensive care units (ICU), were developed by the network HELICS (Hospitals in Europe Link for Infection Control through Surveillance), funded by the European Commission’s Directorate-General for Health and Consumers (DG SANCO), and progressively implemented in Member States by HELICS and later as part of the Improving Patient Safety in Europe (IPSE) project. In July 2008, the coordination of the European surveillance of healthcare-associated infections was transferred from the IPSE network to the European Centre for Disease Prevention and Control (ECDC) in accordance with ECDC’s mandate. ECDC continued HAI surveillance as in HELICS in 2008 and 2009, while changes to the protocols were agreed during the annual meetings of the HAI surveillance network in Stockholm in June 2009 and June 2010. The current protocol describes the methods for the surveillance of healthcare-associated infections in intensive care units (hereafter referred to as ICU-acquired infections) as they were implemented in The European Surveillance System (TESSy) for communicable diseases covered under Decision No 2119/98/EC, in 2010. Surveillance of healthcare-associated infections in intensive care units was previously chosen as a component for European surveillance based on the existence of such networks in several EU Member States, on the fact that patients admitted to intensive care are at 5 to 10 times higher risk of acquiring a nosocomial infection (NI) due to both intrinsic (e.g. immunodepression) and extrinsic (e.g. mechanical ventilation) risk factors, and because the ICU is often the epicentre of emerging problems of healthcare-associated infections and antimicrobial resistance in the hospital. The main objective of this protocol is to ensure standardisation of definitions, data collection and reporting procedures for hospitals participating in the national/regional surveillance of healthcare-associated infections in ICUs across Europe, in order to contribute to the EU surveillance of healthcare-associated infections and to improve the quality of care in the ICU in a multicentre setting. The protocol aims at describing methods for the participating ICUs and the national coordinating centres for the surveillance of healthcare-associated infections