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SDG 3: Antimicrobial resistance

Abstract

BACKGROUND

Mandatory reporting of healthcare-associated infections (HCAI) in England is conducted locally by acute hospital groups and can be a large burden on healthcare staff.

AIM

We aimed to determine the case ascertainment of a potential centrally-implemented, automated HCAI surveillance system in England using preexisting data feeds at the UK Health Security Agency.

METHODS

We compared monthly case numbers submitted between 1 April 2016 and 31 March 2023 by acute hospital groups (locally-implemented surveillance) to routinely-collected laboratory and hospital encounter records (centrally-implemented surveillance) for all infections under mandatory surveillance in England. Since laboratories can serve multiple hospitals, we compared several methods of assigning laboratory-confirmed cases to hospital groups.

RESULTS

Locally-implemented vs centrally-implemented surveillance identified: meticillin-resistant bacteraemias 5,453 vs 5,859 (ratio 1.07), meticillin-susceptible bacteraemias 84,680 vs 83,326 (0.98), bacteraemias 281,100 vs 275,133 (0.98), species bacteraemias 65,877 vs 67,301 (1.02), bacteraemias 25,862 vs 25,715 (0.99), infections (CDI) 94,054 v 90,942 (0. 97) respectively. Assigning hospital groups by linking laboratory records to hospital encounters produced lower monthly mean absolute difference (MAD) vs locally-implemented surveillance than using laboratory records alone. MAD was 0.65 cases/month for bacteraemias, 2.99 for CDI; differences occurred in both directions. MAD decreased over time for bacteraemias but increased from April 2021 onwards for CDI.

CONCLUSION

Centrally-implemented surveillance could be feasible for bacteraemias in England due to comparable case numbers with local surveillance. However, more research is needed around understanding and managing data quality of automated feeds, particularly for CDI.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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2025-10-23
2025-11-12
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Case ascertainment of a potential centrally-implemented, automated system for national surveillance of healthcare-associated infections, England, 2016 to 2023
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Jack+Cregan&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Cregan Jack</a>, <a href="/search?value1=Olisaeloka+Nsonwu&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Nsonwu Olisaeloka</a>, <a href="/search?value1=Dimple+Chudasama&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Chudasama Dimple</a>, <a href="/search?value1=Susan+Hopkins&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hopkins Susan</a>, <a href="/search?value1=Berit+Muller-Pebody&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Muller-Pebody Berit</a>, <a href="/search?value1=Russell+Hope&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hope Russell</a>, <a href="/search?value1=Ann+Sarah+Walker&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Walker Ann Sarah</a>, <a href="/search?value1=Thai+Phuong+Quan&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Quan Thai Phuong</a></span>. Case ascertainment of a potential centrally-implemented, automated system for national surveillance of healthcare-associated infections, England, 2016 to 2023. <a href="/content/ecdc">Euro Surveill.</a> 2025;30(42):pii=2500066. <a href="https://doi.org/10.2807/1560-7917.ES.2025.30.42.2500066" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2025.30.42.2500066</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 21 Jan 2025;&nbsp;&nbsp; <span class="generated">Accepted</span>: 22 May 2025 </span> </p>
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