Data capture of a potential centrally-implemented system for national surveillance of bloodstream infections in England, 2023-2024

Background: Mandatory reporting of bacteraemias in England is currently conducted locally by acute hospital groups; the associated manual data retrieval and entry can be a large burden on healthcare staff. Secondary use of routinely-collected data could provide an alternative. Methods: We compared agreement between individual bacteraemia cases submitted by acute hospital groups (locally-implemented surveillance) and those identified by linking routinely-collected laboratory and hospital encounter records (centrally-implemented surveillance) for all bacteraemias under mandatory surveillance in England from April 2023-March 2024. We considered agreement in case identification between locally-implemented and centrally-implemented surveillance, and completeness and agreement in 17 data-fields covering patient identifiers, location, admission characteristics and acquisition source. Results: 71556/73807 (97.0%) locally-identified bacteraemias were matched vs 71556/72883 (98.2%) centrally-identified. Discrepancies were predominantly restricted to specific hospital groups. Only 1941/71556 (2.7%) matched bacteraemias had >1 day between index specimen collection dates; most discrepancies came from one laboratory. 97.9% centrally-identified bacteraemias could be linked to a hospital encounter. Centrally-generated data-fields were as or more complete than locally-reported fields, with much higher completeness for acquisition source fields. Overall agreement was high, but varied by type of data-field (some being harder to identify from electronic sources) and more markedly across Reporting Organisations. Conclusion: Given the lack of a clear gold-standard, and provided data feeds and quality are monitored continuously, centrally-implemented surveillance could be feasiblefor bacteraemias in England. This could provide greater breadth and depth of intelligence to drive action to reduce healthcare-associated infections, while reducing burden on local hospital groups.