Efficient surveillance for healthcare-associated infections spreading between hospitals

Proc Natl Acad Sci U S A. 2014 Feb 11;111(6):2271-6. doi: 10.1073/pnas.1308062111. Epub 2014 Jan 27.


Early detection of new or novel variants of nosocomial pathogens is a public health priority. We show that, for healthcare-associated infections that spread between hospitals as a result of patient movements, it is possible to design an effective surveillance system based on a relatively small number of sentinel hospitals. We apply recently developed mathematical models to patient admission data from the national healthcare systems of England and The Netherlands. Relatively short detection times are achieved once 10-20% hospitals are recruited as sentinels and only modest reductions are seen as more hospitals are recruited thereafter. Using a heuristic optimization approach to sentinel selection, the same expected time to detection can be achieved by recruiting approximately half as many hospitals. Our study provides a robust evidence base to underpin the design of an efficient sentinel hospital surveillance system for novel nosocomial pathogens, delivering early detection times for reduced expenditure and effort.

Keywords: network; patient referrals.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cross Infection / epidemiology*
  • Cross Infection / transmission
  • England / epidemiology
  • Hospitals*
  • Humans
  • Netherlands / epidemiology
  • Population Surveillance*