Using syndromic surveillance to estimate baseline rates for healthcare-associated infections in critical care units of small animal referral hospitals

Background: Expected rates of healthcare-associated infections (HCAI) have not been established in veterinary hospitals. Baseline rates are critically needed as benchmarks for quality animal care. Objective: To estimate the occurrence of events related to HCAI identified using a standardized syndromic surveillance system in small animals in critical care cases at referral hospitals. Animals: Weaned dogs and cats (n = 1,951) that were hospitalized in the critical care unit of referral teaching hospitals during a 12-week period. Methods: Multicenter, prospective longitudinal study. A survey was completed for all enrolled animals to record basic demographics, information about procedures and treatments that animals received, and to document the occurrence of defined nosocomial syndromes. Data were analyzed to identify risk factors associated with the occurrence of these nosocomial syndromes. Results: Controlling for hospital of admission, 16.3% of dogs (95% confidence intervals [CI], 14.3-18.5) and 12% of cats (95% CI, 9.3-15.5) were reported to have had ≥1 nosocomial syndrome occur during hospitalization. Risk factors found to have a positive association with the development of a nosocomial syndrome were longer hospital stays, placement of a urinary catheter, surgical procedures being performed, and the administration of antiulcer medications and antimicrobial drugs excluding those given perioperatively. Conclusions and Clinical Importance: Syndromic surveillance systems can be successfully standardized for use across multiple hospitals to effectively collect data pertinent to HCAI rates and risk factors for occurrence.