INTRODUCTION The surveillance of nosocomial infections (NIs) is necessary for assessing how hospitals perform regarding infection prevention and patient safety. The number of Nis can be measured by incidence and prevalence studies. Prevalence studies, although not suitable for in‐depth analysis, are useful instruments as they are less time‐consuming than incidence studies. This means that they can be conducted throughout the hospital – thus providing an overview of possible problem areas that merit further analysis. At the national level, prevalence surveys give insight into the total burden of NI. European studies show the prevalence of nosocomial infections to vary between 6.1% and 10.7%.1–7 In The Netherlands, PREZIES– which is a national, non‐mandatory network for the surveillance of NI – collects data on the occurrence of NI. PREZIES is the Dutch acronym for ‘prevention of hospital‐acquired infections by surveillance’. Before national NI prevalence data for The Netherlands became available, data from the incidence‐based PREZIES surveillance of surgical site infections(SSI), central venous catheter‐related bloodstream infection(CR‐BSI) and ventilator‐associated pneumonia (VAP) indicated that the burden of NI appeared to be comparable with that of neighbouring countries. Nosocomial infections are associated with increased morbidity, hospital stay, mortality and costs.8,9 Superficial SSIs in The Netherlands have been associated with additional costs of €900 to €2700 per infection and deep SSI as high as €3200 to €19900.10 Data on the extra costs involved for other types of NI are not available for The Netherlands but these are also expected to be substantial. Many Dutch hospitals have in the past performed prevalence surveys, conducted according to different local protocols, but only a few have published their data.11 Therefore in order to obtain national estimates of the prevalence of NIs for all types of infection and to increase inter‐hospital comparability, the PREZIES network collaborated with ZIEN (working party for Hospital Acquired Infection Epidemiology in The Netherlands) and developed a national protocol in 2007. In accordance with this protocol, national prevalence surveys are organized twice yearly, in March and October. This article discusses the results of the first four surveys in 2007 and 2008. METHODS Setting After a pilot study involving five hospitals, all hospitals in The Netherlands were invited to participate and attend a workshop where the PREZIES protocol and definitions were explained. Collecting the surveillance data was usually done by a team of infection control practitioners (ICPs) and medical microbiologists. These ICPs then visited the 5 91 Prevalence of nosocomial infections: first four national studies
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