Healthcare-Associated Infections Surveillance System in the United States: Past, Present and Future

Abstract

 The National Nosocomial Infections Surveillance (NNIS) system was established in 1970 by the Centers for Disease Control and Prevention of the United States. As the world's first surveillance system for healthcare associated infections, experience has resulted in gradual changes over time. The NNIS transitioned to the National Healthcare Safety Network (NHSN) in 2006. Numerous surveillance components were added in this process. The number of participating hospitals increased sharply, and the amount of collected data now allows use as a benchmark for individual hospitals. On the other hand, the system changes the surveillance definition of infections very frequently. In addition, the public reporting policy which was implemented in many of the states in the late 2000s seemed to reduce the quality of the data, with apparently low infection rates in both device-associated infections and surgical site infections. The present study overviews the development of the world's biggest infection surveillance systems, the NNIS and NHSN, to clarify the direction of the national surveillance system.