Introduction

Data on bacteraemia caused by selected pathogens is currently collected as part of the European Antimicrobial Resistance Surveillance Network (EARS-Net). EARS-Net has proved very successful in Ireland providing valuable data on antimicrobial resistance in Ireland. Additional data on episodes of bloodstream infections reported to EARS-Net has been collected since 2004 through the enhanced programme.

The purpose of the enhanced programme is to help guide local and national strategies for healthcare-associated infection, and antimicrobial resistance prevention and control. Data from the enhanced EARS-Net system can identify changes in the association of infection over time (e.g., community or healthcare-associated), identify potentially preventable sources of bloodstream infection (e.g., IV lines and urinary catheters) and enable this information to help track the progress of improvement programmes. The ultimate aim is to improve overall patient safety.

Method Overview

The updated protocol and the data entry tool are available from the HPSC website.

A minimal dataset is requested for each bloodstream infection reported to EARS-Net isolate. The dataset has been selected to reflect the type of data routinely gathered as part of clinical liaison by microbiologists and the local infection control team.

The data should be reported using this “Enhanced EARS-Net Surveillance” protocol onto an MS Excel, after suitable encryption. Data should be collected quarterly, along with the corresponding EARS-Net isolate data. Participation to the enhanced programme is voluntary but encouraged.

Laboratories should report using current EARS-Net surveillance definitions. The first invasive isolate of a pathogen under EARS-Net surveillance per patient per quarter should be reported. For the purposes of the protocol this only includes blood culture isolates of Staphylococcus aureus, Streptococcus pneumoniae and Escherichia coli, Enterococcus faecium, E. faecalis, Klebsiella pneumoniae and Pseudomonas aeruginosa.

Participants may supply data for S. aureus blood stream infection at a minimum, but are encouraged to submit data on all EARS-Net pathogens. Participants may supply data to LEVEL 1 only (healthcare and device-association), but are encouraged to submit data to LEVEL 2 also (source and outcome). Many hospitals are unable to find data on antibiotic exposure, however, they may still continue to participate.

• Core data
  • Matched records with EARS-Net resistance data for each isolate
  • Level 1
    • Is the isolate a contaminant?
    • Is the infection healthcare-associated and was it acquired in the reporting hospital?
    • Were there devices, procedures or implants involved in the infection?
    • Level 2
      • From which organ site did the infection originate?
      • To which antibiotics was the patient exposed to?
      • What was the outcome of the patient?

Definitions and detailed data entry procedures are available with the protocol.

 Ajay Oza, Stephen Murchan and Robert Cunney, HPSC