Surveillance and control of nosocomial infections: EPINE, VICONOS, PREVINE, ENVIN-ICU

Abstract

Nosocomial infections continue to be an important problem in public health. Epidemiological surveillance (systematic gathering, tabulation, analysis and distribution of the information on nosocomial infections) has proved to be efficient in the prevention of such infections, besides being economically profitable. The surveillance systems are classified as active or passive depending on who carries them out; retrospective of prospective depending on when they are realised; based on the patient or on laboratory data; and finally, according to the area included in the surveillance, global, by target or limited (directed). The use of one or another system basically depends on available resources and the hospital structure. The exhaustiveness of data gathering can vary from the number of infections and the number of patients at risk, to characteristics of the infection (location, culture), intrinsic and extrinsic risk factors, characteristics of the intervention and antibiotic treatment. Results are expressed in a different form depending on whether prevalence or incidence studies are involved. The comparability of the rates basically depends on the comparability of the patients and the surveillance systems employed, hence one of the greatest future challenges is the drawing up of criteria, risk indicators that prove to be good predictors of nosocomial infection. At present, the principal surveillance systems used in Spain are the EPINE, VICONOS, PREVINE and ENVIN-ICU studies.