First steps in establishing surveillance of bloodstream infections from electronic health record derived data, EU/EEA countries, March 2023 to March 2025

BACKGROUNDEnhancing surveillance of bloodstream infections (BSIs) by extracting data from electronic health records (EHR) is often the first step in automating the surveillance of healthcare-associated infections (HAIs).AIMWe assessed existing BSI surveillance systems and the progress in implementing EHR-BSI surveillance within the ECDC project Surveillance from Electronic Health Data (SUREHD).METHODSWe summarised information on BSI surveillance systems through meetings with national representatives and review of national surveillance protocols and reports.RESULTSOf the 30 EU/EEA countries invited to join the SUREHD project, 17 actively participated from March 2023 to March 2025. All 17 countries conducted BSI surveillance within HAI or antimicrobial resistance programmes, and EHR-BSI surveillance was being implemented nationally (n = 9), regionally (n = 2) or at hospital level (n = 6). Reported challenges included data standardisation (n = 13), IT capacity (n = 10), data linkage (n = 7), system integration (n = 7) and data protection (n = 6). Few countries had access to structured EHR data on patient symptoms (n = 1), infection origin (n = 2) and catheter-related variables (n = 5). Most countries had not yet implemented data validation processes (n = 12) nor decided on standardised vocabularies for most variables. All countries aimed to automate EHR-BSI surveillance.CONCLUSIONAutomation of BSI surveillance is critically relevant for the development of surveillance systems and to support infection and control measures (IPC) for HAIs. Implementation of automated EHR-based BSI surveillance varied between countries; a generic protocol and a network of experts have established a way forward. Future efforts should focus on harmonisation, data quality, and leveraging EHR-BSI data to strengthen HAI surveillance and to improve IPC.

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Publication Details

Journal
Eurosurveillance
Published
2026-06-25
DOI
https://doi.org/10.2807/1560-7917.es.2026.31.25.2500618
Primary Topic
Antibiotic Use and Resistance
Type
article
Field-Weighted Citation Impact
0.00
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article

First steps in establishing surveillance of bloodstream infections from electronic health record derived data, EU/EEA countries, March 2023 to March 2025

Imke Wieters, Torunn Alberg, Hanne‐Dorthe Emborg, A Nardone et al.
Eurosurveillance
Antibiotic Use and Resistance
article

First steps in establishing surveillance of bloodstream infections from electronic health record derived data, EU/EEA countries, March 2023 to March 2025

Imke Wieters, Torunn Alberg, Hanne‐Dorthe Emborg, A Nardone, Diamantis Plachouras, Markella Marcou, Linos Hadjihannas, Olov Aspevall, Bernhard Benka, Piret Mitt, Hanna Billström, Michael Borg, Agnese Comelli, Tine Dalby, A Brincat, Pilar Gallego, Nathalie Shodu, Anders Skyrud Danielsen, Francisco Orchard, Liidia Dotsenko, García-San Miguel L, Irena Klavs, Alexis Sentís, Emanuel Brađašević, Antonis Maragkos, A D’Ambrosio, Manon Brekelmans, Antea Jezidžić, Stephanie van Rooden, Fortunato D’Ancona, Alexandra Hoffmann, Auguste Salnaite, Carlos Carvalho, Karl Mertens, Tommi Κärki, Louise Stougaard, on behalf of the EHR-BSI working group, Jan Kubele, Daša Kavka, Sophie Gubbels, Miriam Van den Nest
article en

Abstract

BACKGROUNDEnhancing surveillance of bloodstream infections (BSIs) by extracting data from electronic health records (EHR) is often the first step in automating the surveillance of healthcare-associated infections (HAIs).AIMWe assessed existing BSI surveillance systems and the progress in implementing EHR-BSI surveillance within the ECDC project Surveillance from Electronic Health Data (SUREHD).METHODSWe summarised information on BSI surveillance systems through meetings with national representatives and review of national surveillance protocols and reports.RESULTSOf the 30 EU/EEA countries invited to join the SUREHD project, 17 actively participated from March 2023 to March 2025. All 17 countries conducted BSI surveillance within HAI or antimicrobial resistance programmes, and EHR-BSI surveillance was being implemented nationally (n = 9), regionally (n = 2) or at hospital level (n = 6). Reported challenges included data standardisation (n = 13), IT capacity (n = 10), data linkage (n = 7), system integration (n = 7) and data protection (n = 6). Few countries had access to structured EHR data on patient symptoms (n = 1), infection origin (n = 2) and catheter-related variables (n = 5). Most countries had not yet implemented data validation processes (n = 12) nor decided on standardised vocabularies for most variables. All countries aimed to automate EHR-BSI surveillance.CONCLUSIONAutomation of BSI surveillance is critically relevant for the development of surveillance systems and to support infection and control measures (IPC) for HAIs. Implementation of automated EHR-based BSI surveillance varied between countries; a generic protocol and a network of experts have established a way forward. Future efforts should focus on harmonisation, data quality, and leveraging EHR-BSI data to strengthen HAI surveillance and to improve IPC.

EurosurveillanceVol. 31(25)
Statens Serum Institut (DK), Public Health Agency of Sweden (SE), Norwegian Institute of Public Health (NO), Robert Koch Institute (DE), Istituto Superiore di Sanità (IT), Mater Dei Hospital (MT), Tartu University Hospital (EE), University Medical Center Utrecht (NL), Directorate of Health (IS), Veterinary and Food Board (EE), Ministry of Health (ES), National Institute for Public Health and the Environment (NL), Media Working Group (US), National Institute of Public Health (SI), National Laboratory of Health, Environment and Food (SI), National Institute of Public Health (CZ), Ministry of Health (CY), Sciensano (Belgium) (BE), Institute for Medical Research and Occupational Health (HR), Institute for Medical Informatics and Biostatistics (CH), Austrian Agency for Health and Food Safety (AT), European Centre for Disease Prevention and Control (SE), Hellenic Center for Disease Control & Prevention (GR)
Partnerships for the goals
Openalex Percentile: Top 7%
Antibiotic Use and Resistance
DOIOpen Access PDFOpenAlex
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