Sep 29: Towards (semi-)automated surveillance of healthcare-associated infections
How many wound infections develop after surgery? Can one reliably measure these infections with the help of an algorithm, without taking extra time from healthcare personnel? And does such an algorithm also work in other hospitals? This is the content of Janneke Verberk's dissertation, which she defended on September 29, 2022 at Utrecht University.
Infections that develop within a healthcare institution – simply called healthcare-associated infections (HAIs) – can often be prevented. However, it is important to first find out how and how often these occur. This type of monitoring is also referred to as 'surveillance' and is often performed manually: an infection control practitioner examines each patient record to see whether a patient meets the requirements for a HAI. The studies in the dissertation by Janneke Verberk (Department of Medical Microbiology, UMC Utrecht) show that this current method of surveillance is very labour-intensive, and that the infection rate figures are not suitable for making comparisons between hospitals.
Algorithm improves surveillance
The PhD research by Janneke Verberk showed that an algorithm that uses existing information from hospital information systems can help to reliably find patients with HAIs. Not only does this save time, her thesis also demonstrated that more infections are found than when surveillance is performed manually. These algorithms are also applicable in hospitals other than just an academic hospital. However, there are still barriers that hinder large-scale implementation of these algorithms: the group of patients to which the algorithm is applied could not be selected automatically, and the extra information needed for the interpretation of the surveillance results was not always properly recorded in the hospital information system.
Healthcare-associated infections
HAIs are infections that patients can acquire during their stay in a healthcare facility, such as hospitals or nursing homes. HAIs can develop at each body site or organ system, but are often associated with devices used in care, such as catheters and ventilators, or related to operative procedures such as surgical site infections. On a daily basis, 3.5–10.5 percent of patients acquire a HAI in Europe, resulting in approximately 4 million patients with a HAI and 37,000 deaths each year. Thereby, higher rates are reported for intensive care units and high risk populations. Although sometimes HAIs can be treated easily, in the majority of patients HAIs lead to prolonged hospital stays, increased use of antimicrobial agents, increased morbidity, excess deaths and high burden and costs for health systems, patients and their family. Especially if the HAI is caused by an antimicrobial-resistant microorganism, treatment can be difficult or even impossible with detrimental consequences for the patient.
PhD defense
Janneke Verberk (1992, Utrecht) defended her PhD thesis on September 29, 2022 at Utrecht University. The title of her thesis is “Towards (semi-)automated surveillance of healthcare-associated infections.” Supervisor was prof. dr. Marc Bonten (Research Program Epidemiology of Infectious Diseases, UMC utrecht). Co-supervisors were dr. Sabine de Greeff (National Institute of Public Health and the Environment, Bilthoven) and dr. Maaike van Mourik (Department of Medical Microbiology, UMC Utrecht). Janneke works as assistant professor and clinical project manager at the Julius Center and ECRAID (European clinical research alliance on infectious diseases)