automated detection of external ventricular and lumbar drain-related meningitis using laboratory and microbiology results and medication data自动检测外部心室和腰椎drain-related脑膜炎使用实验室和微生物学和药物的数据结果.pdf

Automated Detection of External Ventricular and Lumbar Drain-Related Meningitis Using Laboratory and Microbiology Results and Medication Data 1 2 3 Maaike S. M. van Mourik *, Rolf H. H. Groenwold , Jan Willem Berkelbach van der Sprenkel , Wouter W. 4 1 1,2 van Solinge , Annet Troelstra , Marc J. M. Bonten 1 Department of Medical Microbiology, University Medical Centre Utrecht, Utrecht, The Netherlands, 2 Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands, 3 Department of Neurosurgery, University Medical Centre Utrecht, Utrecht, The Netherlands, 4 Department of Clinical Chemistry and Hematology, University Medical Centre Utrecht, Utrecht, The Netherlands Abstract Objective: Monitoring of healthcare-associated infection rates is important for infection control and hospital benchmarking. However, manual surveillance is time-consuming and susceptible to error. The aim was, therefore, to develop a prediction model to retrospectively detect drain-related meningitis (DRM), a frequently occurring nosocomial infection, using routinely collected data from a clinical data warehouse. Methods: As part of the hospital infection control program, all patients receiving an external ventricular (EVD) or lumbar drain (ELD) (2004 to 2009; n = 742) had been evaluated for the development of DRM through chart review and standardized diagnostic criteria by infection control staff; this was the reference standard. Children, patients dying ,24 hours after drain insertion or with ,1 day follow-up and patients with infection at the time of insertion or multiple simultaneous drains were excluded. Logistic regression was used to develo