Table 2.
Article | Study setting and size | HAI types | Data sources used | Data description | Sensitivity [PPV] (%) | Specificity [NPV] (%) |
---|---|---|---|---|---|---|
Bellini et al33 | University hospital, 669 episodes | BSI, CRI | Microbiology results | Positive blood and CVC cultures | 89.7* | 83.9* |
Klompas et al35 | Academic hospital, 459 patients | VAP | Microbiology results; biochemistry results; radiology results; clinical patient data |
Gram stains of excretion samples; abnormal leukocyte count; radiological signs of pneumonia; PEEP and FiO2 values, presence of fever | 95 [100] | – |
Woeltje et al32 | Tertiary care academic hospital, 540 patients | CRI | Microbiology results | Positive wound, urine or respiratory device cultures | 94.3 [22.8] | 68 [99.2] |
Claridge et al36 | Level I trauma center, 769 patients | VAP | Pharmacy dispensing records; microbiology results; clinical patient data |
Antimicrobial treatment records, positive cultures, patient vital signs and presence of devices | 97 [100] | 100 [99.9] |
Bolon et al24 | HMO, 6322 procedures | SSI | Procedure and discharge codes; pharmacy dispensing records | ICD-9-CM codes; Antimicrobial administration with an infection-specific interval | 86–93 [25–39] | – |
Leth et al25 | Community hospitals, 1512 women | SSI, UTI | Procedure and discharge codes; pharmacy dispensing records; microbiology results | ICD-10 and NCSP codes; ATC codes for antimicrobial administration; positive urine or wound cultures | 74* [81.7*] | 99.4* [99.3*] |
Koller et al28 | Tertiary care and teaching hospital, 99 patients | UTI, BSI, CRI, pneumonia | Microbiology results; biochemistry results; clinical patient data | Positive cultures; Abnormal leukocyte count or CRP values; Clinical data from a patient data management system | 90.3 [100] | 100 [95.8] |
Shaklee et al37 | Pediatric hospitals, 119 patients | CDI | Procedure and discharge codes | ICD-9-CM codes | 80.7 [73.95] | 99.9 [99.9] |
Inacio et al26 | HMO, 42 173 procedures | SSI | Procedure and discharge codes; physician narratives | ICD-9-CM codes; standardized postoperative forms | 97.8 [11] | 91.5 [100] |
Bouzbid et al29 | University hospital, 1499 patients | UTI, BSI, CRI pneumonia | System 1 physician narratives System 2 pharmacy dispensing records; microbiology results |
Electronic discharge summaries ATC codes for antimicrobial administration; positive cultures of non-common skin contaminants |
86.7 99.3 [34.7] |
88.2 56.8 [99.7] |
Choudhuri et al30 | University affiliated urban teaching hospital, 136 patients | Catheter-associated UTI | Microbiology results; biochemistry results; clinical patient data | Positive cultures; presence of fever and urinary tracts; abnormal leukocyte count | 86.4 [85] | 93.8 [94.4] |
van Mourik et al38 | Tertiary healthcare centre, 537 patients | Drain-related meningitis | Pharmacy dispensing records; microbiology results; biochemistry results | Number and exposure time of antimicrobial drugs; positive cerebrospinal fluid and drain cultures; abnormal leukocyte and CRP values | 98.8 [56.9] | 87.9 [99.9] |
Chang et al40 | Academic teaching medical center, 476 patients | Device-related | Procedure and discharge codes; pharmacy dispensing records | ICD-9-CM codes; administration of steroids | 92.4–96.6 [70.6–79.1] | 86.0–91.5 [97.2–98.7] |
*Indicates that metrics were (re-)calculated from data provided in the publication.
ATC, Anatomical Therapeutic Chemical; BSI, bloodstream infection; CRI, CVC-related infection; CRP, C reactive protein; CVC, central venous catheter; HAI, healthcare-associated infection; HMO, health maintenance organization; ICD-9-CM, International Classification of Diseases 9th revision, clinical modification; NCSP, NOMESCO Classification of Surgical Procedures; NPV, negative predictive value; PEEP, positive end-expiratory pressure; PPV, positive predictive value; SSI, surgical site infection; UTI, urinary tract infection; VAP, ventilator-associated pneumonia.