Patients in intensive care units (ICUs) have an increased risk of acquiring nosocomial infections because they are more often subject to invasive procedures and often already have severe illnesses.

Since 1997, nosocomial infections have been recorded by an increasing number of ICUs in all of Germany through voluntary participation in KISS, a hospital infection surveillance system run out of the National Reference Center for  Nosocomial Infection Surveillance.

Because of their frequency and severity, KISS surveillance on ICUs concentrates on lower respiratory infections (pneumonia and bronchitis), sepsis, and urinary tract infections. When especially relevant for an ICU, ITS-KISS (Intensivstation=ICU, abbrev. ITS) can also be used for surveillance of external ventricular drainage-associated meningitis/ventriculitis. The use of devices (e.g., urinary tract catheters, central vascular catheters, invasive or non-invasive mechanical ventilation, or external ventricular drainage) is also taken into account during analysis as a risk factor for the development of nosocomial infections.

Participating ICUs transfer their data to the NRZ, making an evaluation of device usage rates and device-associated infection rates possible for each ICU.

Moreover, the data of all ICUs for the complete time period is summarized and made available as reference data for comparison.

In addition, a stratification of rates according to the kind of ICU is undertaken in order to include the different kinds of underlying patient illness on different kinds of ICUs. In this way, important predisposing factors and risks related to exposure are taken into account. Differences between hospitals or time periods can be important signs of problems that should be investigated more closely.

When needed, surveillance of other nosocomial infections can be undertaken on the ICU.

Documents in English relevant for participation in this component will be posted here in the next few months.

Kohlenberg A, Schwab F, Behnke M, Geffers Ch, Gastmeier P.
Pneumonia associated with invasive and noninvasive ventilation: an analysis of the German nosocomial infection surveillance system database.
Intensive Care Med 2010; 36(): 971-8.

Meyer E, Sohr D, Gastmeier P, Geffers C.
New idendification of outliers and ventilator-associated pneumonia rates from 2005 to 2007 within the german Nosocomial Infection Surveillance System.
Journal of Hospital Infection 2009; 73(): 246-252.

Kohlenberg A, Schwab F,Geffers C, Behnke M, Rüden H, Gastmeier P.
Time-trends for gram-negative and multidrug-resistant gram-positive bacteria associated with nosocomial infections in German intensive care units between 2000 and 2005.
Clin Micro Infect 2008, 14(): 93-96.

Gastmeier P, Sohr D, Geffers C, Behnke M, Rüden H.
Risk factors for death due to nosocomial infection in intensive care unit patients: findings from the Krankenhaus Infektions Surveillance System.
Infect Control Hosp Epidemiol. 2007 Apr; 28(4):466-72.