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] |