Surveillance of infections in nursing homes in the Netherlands, how to come from information to action

Abstract

The SNIV network is a national surveillance system involving nursing homes on a voluntary base. The aim of the SNIV network is to provide systematic year-round surveillance data on the incidence of infections in nursing homes for local interventions and national policymaking and for the development of infection control guidelines. The network was designed as a sentinel active surveillance network involving nurse practitioners and/or elderly care physicians who report weekly on incident infectious diseases (gastro-enteritis, influenza-like illness, probable pneumonia and the addition of urinary tract infections in 2011) in their nursing home based on clinical definitions. The average weekly incidence per 1000 residents in the years 2009 till 2012 varied by year: gastro-enteritis: 3.8, 4.6, 3.7, 2.5; influenza-like illness: 1.6, 0.4, 0.5, 1.8; probable pneumonia: 3.6, 3.7, 2.9, 3.5; urinary tract infections: 8.0, 9.6 per 1000 resident weeks in 2011 and 2012. Gastro-enteritis most frequently occurred in local outbreaks and incidence peaked in winter. Incidence of influenza-like illness only showed a seasonal pattern in 2009 due to absence of infections with A(H1N1) influenza virus in nursing home residents. The results from our nationwide on-going weekly surveillance into the incidence of infections in nursing homes show that systematic surveillance in nursing homes is feasible. These data provides insight into seasonal patterns and risk factors for infection needed to guide infection control efforts and form the basis for comparisons between institutions and within regions. Furthermore, these data provide a solid baseline when studying the effectiveness of intervention strategies in the nursing home setting.