The potential of a centrally implemented system for national surveillance of bloodstream infections in England, compared to current local surveillance, 2023-2024.
Cregan J., Nsonwu O., Chudasama D., Hopkins S., Muller-Pebody B., Hope R., Brown C., Eyre DW., Quan TP., Walker AS.
BACKGROUND: Mandatory reporting of bacteraemias in England is currently conducted locally by acute hospital groups. Secondary use of routinely collected data could provide an alternative. AIM: To assess the desirability of replacing the current local manual method of surveillance with a centrally implemented automated alternative. METHODS: We compared agreement between individual bacteraemia cases submitted by acute hospital groups (locally implemented surveillance) and those identified by linking routinely collected laboratory and hospital encounter records (centrally implemented surveillance) for bacteraemias under mandatory surveillance in England from April 2023 to March 2024. We considered agreement in case identification, and completeness and agreement in 17 data-fields covering patient identifiers, location, admission characteristics, and acquisition source. FINDINGS: In all, 71,556 out of 73,807 (97.0%) locally identified bacteraemias were matched vs 71,556 out of 72,883 (98.2%) centrally identified. Discrepancies were predominantly restricted to specific hospital groups. Only 1941 out of 71,556 (2.7%) matched bacteraemias had >1 day between index specimen dates; most discrepancies came from one laboratory; 97.9% centrally identified bacteraemias linked to a hospital encounter. Centrally generated metadata-fields were as or more complete than locally reported fields, with much higher completeness for acquisition source fields. Overall agreement was high, but this varied by type of data-field (some being harder to identify from electronic sources) and more markedly across Reporting Organisations. CONCLUSION: If data feeds and quality are monitored continuously, centrally implemented surveillance could be feasible for bacteraemias in England, providing broader and deeper intelligence to reduce healthcare-associated infections, while reducing burden on local hospital groups.