TECHNICAL DOCUMENT Point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals Protocol version 5.3 www.ecdc.europa.eu ECDC TECHNICAL DOCUMENT Point prevalence survey of healthcare- associated infections and antimicrobial use in European acute care hospitals Protocol version 5.3, ECDC PPS 2016–2017 Suggested citation: European Centre for Disease Prevention and Control. Point prevalence survey of healthcare- associated infections and antimicrobial use in European acute care hospitals – protocol version 5.3. Stockholm: ECDC; 2016. Stockholm, October 2016 ISBN 978-92-9193-993-0 doi 10.2900/374985 TQ-04-16-903-EN-N © European Centre for Disease Prevention and Control, 2016 Reproduction is authorised, provided the source is acknowledged. ii TECHNICAL DOCUMENT PPS of HAIs and antimicrobial use in European acute care hospitals – protocol version 5.3 Contents Abbreviations ............................................................................................................................................... vi Background and changes to the protocol .......................................................................................................... 1 Objectives ..................................................................................................................................................... 3 Inclusion/exclusion criteria .............................................................................................................................. 4 Hospitals .................................................................................................................................................. 4 Wards ...................................................................................................................................................... 4 Patients ................................................................................................................................................... 4 Sample design ............................................................................................................................................... 5 Sampling of patients within the hospital ...................................................................................................... 5 Representative sampling of hospitals (for PPS coordinating centres only) ....................................................... 5 Steps ................................................................................................................................................... 5 Design effect and sample size ................................................................................................................ 5 Other sampling methods: reporting of results and data collection periods .................................................. 7 Data collection ............................................................................................................................................... 8 When? ..................................................................................................................................................... 8 Who will collect the data? .......................................................................................................................... 8 Training of surveyors ................................................................................................................................. 8 Data processing ........................................................................................................................................ 8 Overview of collected data .............................................................................................................................. 9 Light (unit-based) protocol ........................................................................................................................ 9 Standard (patient-based) protocol .............................................................................................................. 9 Hospital data ............................................................................................................................................... 10 Definition of hospital data ........................................................................................................................ 12 Hospital variables to be added by PPS coordinating centre before submission to ECDC’s TESSy ...................... 17 Ward data ................................................................................................................................................... 18 Definition of ward data ............................................................................................................................ 18 Patient data (standard protocol option) .......................................................................................................... 20 Definition of patient data ......................................................................................................................... 20 Antimicrobial use data and HAI data .............................................................................................................. 23 Antimicrobial use data ............................................................................................................................. 23 Definitions of antimicrobial use data ..................................................................................................... 23 Healthcare-associated infection data ......................................................................................................... 24 Key terms and notes ........................................................................................................................... 24 Definitions of healthcare-associated infection data ................................................................................. 25 Recommended case-finding algorithm for healthcare-associated infections............................................... 27 Numerator data in the light protocol ..................................................................................................... 28 National/regional data .................................................................................................................................. 29 Objectives .............................................................................................................................................. 29 Notes..................................................................................................................................................... 29 Definition of national/regional data ....................................................................................................... 29 Data structure and variable names ................................................................................................................ 31 Standard protocol option record types ...................................................................................................... 31 Light protocol option record types ............................................................................................................ 31 Note on microorganism and resistance data .............................................................................................. 31 Acknowledgements ...................................................................................................................................... 33 iii PPS of HAIs and antimicrobial use in European acute care hospitals – protocol version 5.3 TECHNICAL DOCUMENT Annex 1. Additional materials ........................................................................................................................ 39 Codebook............................................................................................................................................... 39 Forms .................................................................................................................................................... 39 TESSy variable definitions and validation rules ........................................................................................... 39 Note on case definitions of healthcare-associated infections ........................................................................ 39 Annex 2. Codebook ...................................................................................................................................... 40 Specialty code list ................................................................................................................................... 40 Diagnosis (site) code list for antimicrobial use ........................................................................................... 42 Indications for antimicrobial use ............................................................................................................... 42 Antimicrobial ATC codes (2016) ................................................................................................................ 43 Healthcare-associated infections: code lists ............................................................................................... 49 HAI code list, table ............................................................................................................................. 49 Definition of active HAI ......................................................................................................................