Table I Criteria for surgical site infection, central venous catheter‐related bloodstream infection and ventilator‐associated pneumoniaᵃ ᵃ Adapted from the Centers for Disease Control and Prevention criteria. Surgical site infection (SSI) All infections should meet the following criteria: for supercial SSI: 1. Infection of skin or subcutaneous tissue develops within 30 days after the operative procedure and 2. Purulent drainage from incision or Clinical symptom(s) (pain, tenderness, localised swelling, redness or heat) and o a positive culture or o surgeon opens incision deliberately (unless wound culture is negative). for deep SSI (including SSI from organ/ anatomical space): 1. Infection of fascia, muscle or organ/antomical space develops within 30 days after the operative procedure or within a year when non‐human‐derived material was implanted and 2. Purulent drainage from deep incision or drain or Abscess or other sign of infection on direct observation, during reoperation or by histopathological or radiological investigation or Clinical symptom(s) (pain, tenderness, localised swelling, redness, heat, fever>38C) and o spontaneous wound dehiscence or o surgeon opens incision deliberately (unless wound culture is negative) or o positive culture of uid or tissue (in case of surgery in organ/anatomical space) Central venous catheter‐related bloodstream infection (CR‐BSI) All infections should meet the following criteria: 1. Central venous catheter present for at least 48 h or was present until at most 24 h ago and 2. Fever (>38 ᵒC), hypotension (<100 mmHg) or chills and 3. One of the following: o Positive blood culture by venepuncture or from an arterial catheter and positive semiquantitative culture of a catheter segment with the same micro‐organism or o positive blood culture by venepuncture and positive qualitative culture of a catheter segment with the same micro‐organism or o positive blood culture by venepuncture and central venous catheter remains in situ and symptoms disappear within 48 h after start of therapy or o no blood and/or catheter segment culture done and symptoms disappear within 24 h after removal of central venous catheter and 4. No infection with the same micro‐organism present at another body site. Ventilator‐associated pneumonia (VAP) All infections should meet the following criteria: 1. Patient ventilated for at least 48 h or ventilated until at most 24 h ago and 2. At least one chest X‐ray with new or progressive inltrate or cavitation or consolidation and 3. At least one of the following symptoms: o fever (>38 ᵒC) without other apparent reason o leucopaenia (<4000 leucocytes/mm³) o leucocytosis (2:12 000 leucocytes/mm³) and 4. At least one of the following symptoms: o production of purulent sputum o change in character of sputum o worsening gas exchange. Patients fullling these criteria are registered as having clinical pneumonia. When a positive culture of tracheal aspirate, bronchoalveolar lavage liquid, etc., is present this leads to different categories of pneumonia but for this prevalence survey no distinction was made. 5 93 Prevalence of nosocomial infections: first four national studies
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