Efficient surveillance for healthcare-associated infections spreading between hospitals

Mariano Ciccolini, Tjibbe Donker, Hajo Grundmann, Marc J M Bonten, Mark E J Woolhouse

Research output: Contribution to journalArticlepeer-review


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.
Original languageEnglish
Pages (from-to)2271-2276
Number of pages6
JournalProceedings of the National Academy of Sciences
Issue number6
Publication statusPublished - 11 Feb 2014

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