Surveillance Analysis and Monitoring of Multidrug-Resistant Bacteria Incidence in an Intensive Care Unit: The Role of Cumulative Sum Control Charts

Hospital surveillance programs focus mainly on detecting warning signs and epidemic events. Control charts are important quality control tools and are recommended for monitoring and improving a process. The aim of this article is to evaluate the role of the tabular cumulative sum control chart as an auxiliary tool to identify the onset of epidemics of multidrug-resistant bacteria in the intensive care unit for adults at the University Hospital of Brasilia, Brazil. A retrospective study is performed on the frequency of multidrug-resistant baterial epidemics. Days between positive cultures are statistically analysed. Cumulative sum control charts are described and applied. The six most prevalent bacterial species are studied. Cumulative sum control charts for methicillin resistant Staphylococcus aureus and Klebsiella pneumoniae are selected to illustrate situations in which the chart highlights possible changes in the state of the epidemic process. Special attention is given to the ability of the Cumulative sum contro