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Table 3 Concordance of HAI definitions, determined by Cohen’s kappa statistic

From: Concordance between European and US case definitions of healthcare-associated infections

Type of HAI or key term Included cases based on: Incidence of HAI (no. cases per 100 patients) No. cases of HAI No. patients without HAI Cohen’s kappa [95% confidence interval]
US definitions European definitions According to either the European or the US definition According to both the European and the US definitions According to the European definition but not the US definition According to the US definition but not the European definition
Pneumonia PNU1 + PNU2 + PNU3 PN1 + PN2 + PN3 +  PN4 + PN5 2.8 180 177 1 2 6,326 0.99 [0.98 ; 1.00]
Clinically defined pneumonia PNU1 PN2 + PN4 + PN5 2.0 127 102 23 2 6,379 0.89 [0.85 ; 0.93]
PNU1 PN4 + PN5 1.8 119 92 15 12 6,387 0.87 [0.82 ; 0.92]
PNU1* PN2 + PN4 + PN5 2.0 127 104 21 2 6,379 0.90 [0.86 ; 0.94]
PNU1* PN4 + PN5 1.8 119 94 13 12 6,387 0.88 [0.83 ; 0.93]
Microbiologically defined pneumonia PNU2 PN1 + PN3 1.0 65 37 16 12 6,441 0.72 [0.63 ; 0.82]
PNU2 PN1 + PN2 + PN3 1.2 78 42 29 7 6,428 0.70 [0.60 ; 0.79]
PNU2† PN1 + PN3 1.1 73 53 0 20 6,433 0.84 [0.77 ; 0.91]
PNU2† PN1 + PN2 + PN3 1.3 84 60 11 13 6,422 0.83 [0.77 ; 0,90]
ICU-acquired pneumonia Pneumonia not present or in incubation at admission Pneumonia occurring >48 h after admission 2.3 147 144 0 3 28 0.94 [0.87 ; 1.00]
Mechanical ventilation Continuous presence of device within 48 hours preceding pneumonia onset Presence of device (even intermittently) within 48 hours preceding pneumonia onset 2.1 136 134 2 0 42 0.97 [0.93 ; 1.00]
Bloodstream infection (BSI) Microorganism is not related to infection at another site Origin of BSI is “catheter”, “secondary to another site” or “unknown” 1.9 123 72 51 0 6,383 0.73 [0.66 ; 0.80]
Primary BSI Microorganism is not related to infection at another site Origin of BSI is “catheter” or “unknown” 1.1 72 72 0 0 51 1.00
ICU-acquired BSI BSI not present or in incubation at admission BSI occurring >48 h after admission 1.5 98 96 0 2 22 0.94 [0.87 ; 1.00]
  1. *Including PNU3 cases (pneumonia in the immunocompromised patient) qualified as PNU1 after redistribution of PNU3 cases into PNU1 or PNU2.
  2. † Including PNU3 cases (pneumonia in the immunocompromised patient) qualified as PNU2 after redistribution of PNU3 cases into PNU1 or PNU2.