Abstract：
BACKGROUND: Surveillance of healthcare-associated infections (HAIs) is an essential component of hospital infection prevention and control systems. We aimed to assess the quality of the data compiled by the Brazilian HAI Surveillance System from pediatric (PICUs) and neonatal intensive care units (NICUs), between 2012 and 2021.
METHODS: Data Quality Review, including adherence, completeness, internal consistency, consistency over time, and consistency of population trend, were computed at both national and state levels based on quality metrics from World Health Organization Toolkit. Incidence rates (or incidence density) of ventilator-associated pneumonia (VAP) and central line-associated bloodstream infection (CLABSI) were obtained from the Brazilian National Nosocomial Infections Surveillance (NNIS) system. Data on sepsis-related mortality, spanning the period from 2012 to 2021, were extracted from the Brazilian National Health Service database (DATASUS). Additionally, correlations between sepsis-related mortality and incidence rates of VAP or CLABSI were calculated.
RESULTS: Throughout the majority of the study period, adherence to VAP reporting remained below 75%, exhibiting a positive trend post-2016. Widespread outliers, as well as inconsistencies over time and in population trends, were evident across all 27 states. Only four states maintained consistent adherence levels above 75% for more than 8 years regarding HAI incidence rates. Notably, CLABSI in NICUs boasted the highest reporting adherence among all HAIs, with 148 periods out of 270 (54.8%) exhibiting reporting adherence surpassing 75%. Three states achieved commendable metrics for CLABSI in PICUs, while five states demonstrated favorable results for CLABSI in NICUs.
CONCLUSIONS: While adherence to HAI report is improving among Brazilian states, an important room for improvement in the Brazilian NNIS exists. Additional efforts should be made by the Brazilian government to improve the reliability of HAI data, which could serve as valuable guidance for hospital infection prevention and control policies.
METHODS: Data Quality Review, including adherence, completeness, internal consistency, consistency over time, and consistency of population trend, were computed at both national and state levels based on quality metrics from World Health Organization Toolkit. Incidence rates (or incidence density) of ventilator-associated pneumonia (VAP) and central line-associated bloodstream infection (CLABSI) were obtained from the Brazilian National Nosocomial Infections Surveillance (NNIS) system. Data on sepsis-related mortality, spanning the period from 2012 to 2021, were extracted from the Brazilian National Health Service database (DATASUS). Additionally, correlations between sepsis-related mortality and incidence rates of VAP or CLABSI were calculated.
RESULTS: Throughout the majority of the study period, adherence to VAP reporting remained below 75%, exhibiting a positive trend post-2016. Widespread outliers, as well as inconsistencies over time and in population trends, were evident across all 27 states. Only four states maintained consistent adherence levels above 75% for more than 8 years regarding HAI incidence rates. Notably, CLABSI in NICUs boasted the highest reporting adherence among all HAIs, with 148 periods out of 270 (54.8%) exhibiting reporting adherence surpassing 75%. Three states achieved commendable metrics for CLABSI in PICUs, while five states demonstrated favorable results for CLABSI in NICUs.
CONCLUSIONS: While adherence to HAI report is improving among Brazilian states, an important room for improvement in the Brazilian NNIS exists. Additional efforts should be made by the Brazilian government to improve the reliability of HAI data, which could serve as valuable guidance for hospital infection prevention and control policies.
摘要：
背景：医疗保健相关感染（HAIs）的监测是医院感染预防和控制系统的重要组成部分。我们旨在评估巴西HAI监测系统从儿科（PICUs）和新生儿重症监护病房（NICUs）收集的数据的质量，2012年至2021年。
方法：数据质量审查，包括坚持，完整性，内部一致性，随着时间的推移一致性，和人口趋势的一致性，是根据世界卫生组织工具包的质量指标在国家和州两级计算的。呼吸机相关性肺炎（VAP）和中央管路相关血流感染（CLABSI）的发生率（或发生率密度）来自巴西国家医院感染监测（NNIS）系统。脓毒症相关死亡率数据，从2012年到2021年，从巴西国家卫生服务数据库（DATASUS）中提取。此外,计算脓毒症相关死亡率与VAP或CLABSI发生率之间的相关性。
结果：在整个研究期间，对VAP报告的依从性保持在75%以下，2016年后呈现积极趋势。广泛的离群值，以及随着时间的推移和人口趋势的不一致，在所有27个州都很明显。只有四个州在超过8年的HAI发病率方面保持一致的依从性水平超过75％。值得注意的是,在所有HAIs中，CLABSI的报告依从性最高，270个周期中有148个（54.8%）报告依从性超过75%。三个州在PICU中实现了CLABSI的值得称赞的指标，而五个州在NICU中显示了CLABSI的良好结果。
结论：虽然巴西各州对HAI报告的依从性正在提高，巴西NNIS存在一个重要的改进空间。巴西政府应做出更多努力来提高HAI数据的可靠性，可作为医院感染防控政策的宝贵指导。
方法：数据质量审查，包括坚持，完整性，内部一致性，随着时间的推移一致性，和人口趋势的一致性，是根据世界卫生组织工具包的质量指标在国家和州两级计算的。呼吸机相关性肺炎（VAP）和中央管路相关血流感染（CLABSI）的发生率（或发生率密度）来自巴西国家医院感染监测（NNIS）系统。脓毒症相关死亡率数据，从2012年到2021年，从巴西国家卫生服务数据库（DATASUS）中提取。此外,计算脓毒症相关死亡率与VAP或CLABSI发生率之间的相关性。
结果：在整个研究期间，对VAP报告的依从性保持在75%以下，2016年后呈现积极趋势。广泛的离群值，以及随着时间的推移和人口趋势的不一致，在所有27个州都很明显。只有四个州在超过8年的HAI发病率方面保持一致的依从性水平超过75％。值得注意的是,在所有HAIs中，CLABSI的报告依从性最高，270个周期中有148个（54.8%）报告依从性超过75%。三个州在PICU中实现了CLABSI的值得称赞的指标，而五个州在NICU中显示了CLABSI的良好结果。
结论：虽然巴西各州对HAI报告的依从性正在提高，巴西NNIS存在一个重要的改进空间。巴西政府应做出更多努力来提高HAI数据的可靠性，可作为医院感染防控政策的宝贵指导。
