Infection Control & Hospital Epidemiology
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Unit, University General Hospital of Larissa, Greece: Caterina Gaitana, Ioanna Grivea, Aikaterini Kaffe, and George Syrogiannopoulos; Neonatal Intensive Care Unit, University Hospital of Ioannina, Ioannina, Greece: Vasileios Giapros, Theodoros Gouvias, and Aikaterini Drougia; Neonatal Intensive Care Unit, General Hospital of Nikaia and Piraeus “Aghios Panteleimon,” Athens, Greece: Georgia Karavana and Martha Theodoraki; Neonatal Intensive Care Unit, Venizelio General Hospital, Heraklion, Greece: Marina Koropouli and Christina Thomou; Neonatal Intensive Care Unit, General - Maternity District Hospital “Helena Venizelou”, Athens, Greece: Anastasia Kapetanaki and Margarita Tzaki; 2nd Neonatal Intensive Care Unit, G.P.N. Papageorgiou Hospital, Aristotle University Faculty of Medicine, Thessaloniki, Greece: Maria Lithoxopoulou and Vasiliki Soubasi; Penteli Children’s Hospital, Athens, Greece: Lida Sianidou and Foteini Zafeiropoulou; Center for Clinical Epidemiology and Outcomes Research (CLEO), Non-Profit Civil Partenrship, Athens, Greece: Polyxeni Karakosta, Sofia Kouni, and Stefania Maistreli.
Fig. 3. Distribution of percentage error of the estimated CLU ratio using the cutoff of 75 central-line (cl) days for the day-pair permutation Monday–Friday in NICUs.
because these were the most feasible in our setting. The available dataset consisted of 6 consecutive months of daily denominator data from each unit. This period may have been rather short to evaluate accuracy; more months may be needed to obtain reli- able results. Especially with regard to PICUs in our dataset, there were 24 months of data compared to other types of units that had more. Moreover, further sensitivity analysis should be conducted to examine whether zero CLABSIs would influence the precision.
Notwithstanding the limitations described above, our findings
further support existing evidence that sampling is a valid alternative to daily active surveillance and can provide reliable rates. More specifically, sampling over 2 fixed days per week seems to provide a more accurate alternative to the daily collection of CLABSI denominator data. Adoption of such monitoring methods in resource-limited healthcare systems, such as in Greece, could be an important step toward better and less burdensome infection control and prevention. These findings should also be evaluated for the surveillance of other healthcare-associated infections.
Acknowledgments. No sponsor was involved in the work reported. Financial support. No financial support was provided relevant to this article.
Conflicts of interest. All authors report no conflicts of interest relevant to this article.
PHIG investigators: General Hospital “Evaggelismos,” Athens, Greece: Maria Filippa, Sofia Kostourou, Athanasios Skoutelis, and Fani Veini; University General Hospital of Athens “Attikon,” Athens, Greece: Christina Logotheti, Vana Papaevangelou, and Pinelopi Triantafyllidou; Children’s Hospital of Athens “Agia Sofia,” University of Athens, Greece: Eleni Fanaraki, Katerina Kaisari, Panagiotis Kalabalikis, Korina Karachristou, Katerina Katsibardi, Antonis Kattamis, Maria Kazantzi, Vasiliki Kitra, Athanasia Lourida, Eleni Mpouza, Stamatia Papadopoulou, Loizos Petrikkos, Sofia Polychronopoulou, and Kirikas Zannikos; Second Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, University General Hospital of Thessaloniki AHEPA, Thessaloniki, Greece: Andreas Gianno- poulos, Emmanouel Hatzipantelis, and Athanasios Tragiannidis; Hippokra- tion Hospital, Thessaloniki, Greece: Elisavet Chorafa and Elias Iosifidis; Second Department of Pediatrics, General Children’s Hospital of Athens “P. & A. Kyriakou,” University of Athens, Greece: Margarita Baka, Chrysanthi Dimolitsa, Dimitrios Doganis, Ioannis Kapetanakis, Georgios Mavrogeorgos, Aggeliki Nika, Smaragda Papachristidou, Ioannis Papadatos, Nikos Spyridis, and Mariza Tsolia; University General Hospital of Patras, Rio, Greece: Gabriel Dimitriou, Despina Gkentzi, and Asimina Tsintoni; Neonatal Intensive Care
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