Current state and potential of hospitals for automated healthcare-associated infection surveillance: data from 24 European countries, 2022 to 2023

Background: Although electronic health records are increasingly used for automated surveillance (AS) of healthcare-associated infections (HAIs), implementation is still a challenge. To develop more targeted implementation initiatives across Europe, knowledge about the current state of AS and potential to implement AS systems is needed. Aim: To assess the adoption and feasibility of AS based on the 2022–2023 European Centre for Disease Prevention and Control (ECDC) Point Prevalence Survey (PPS). Methods: The 2022–2023 ECDC PPS included questions on the degree of AS and digital data storage for seven HAIs. Descriptive analyses of the responses were performed and stratified by geographic region and hospital characteristics. Categorical variables were analysed as such and converted to ordinal scales. Results: Overall, 992 hospitals from 24 European countries participated. Across all seven HAIs, fully manual surveillance was the most common method (from healthcare-associated pneumonia (HAP) 38.8% to Clostridioides difficile infection (CDI) 45.4%). A considerable proportion, i.e. 19.3% (HAP) to 29.8% (CDI), employed some form of automation (automated denominator 5.3–11.3%; semi-automated 12.2–16.9%; fully automated 1.8–2.9%). Many hospitals not employing AS had required source data digitally stored. Generally, tertiary hospitals had higher levels of automation and digital data storage compared with other hospital types. Smaller hospitals (≤ 250 beds) had lower levels of automation, but a similar level of digital data storage compared with larger hospitals. Conclusion: This study highlights variability in AS implementation and digital potential across European hospitals and underscores the need for targeted strategies to advance AS adoption and optimise surveillance.