Two Decades of KONIS-ICU: Achievements and the Role of the Korean Society for Healthcare-associated Infection Control
10.14192/kjicp.2025.30.2.128
- Author:
Doo Ryeon CHUNG
- Publication Type:Review Article
- From:
Korean Journal of healthcare-associated Infection Control and Prevention
2025;30(2):128-137
- CountryRepublic of Korea
- Language:English
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Abstract:
In 2006, the Korean Society for Healthcare-associated Infection Control (KOSHIC) launched the Korean National Healthcare-associated Infections Surveillance System (KONIS) program under the auspices of the Korea Centers for Disease Control and Prevention (currently the Korea Disease Control and Prevention Agency, KDCA). Since then, KONIS has served as the nationwide platform for intensive care unit (ICU) surveillance in Korea. This narrative review summarizes the evolution and performance of KONIS-ICU over the past 20 years and discuss its future directions. Building on standardized case definitions, indicators, and a webbased data-reporting platform, the KONIS has expanded from a single ICU module to seven surveillance modules and now engages a large proportion of acute-care hospitals, enabling interhospital benchmarking and policy support. The data quality was strengthened over time through uniform manuals, routine training, helpdesk support, and regular internal and external validity assessments. Trends in the KONIS-ICU reports have indicated a sustained decline in the burden of healthcare-associated infections (HAIs) over the past two decades. In a recent report (July 2023 to June 2024), the overall HAI incidence was 3.15 per 1,000 patientdays; device-associated infection rates were 1.16 per 1,000 urinary catheter-days for catheterassociated urinary tract infection, 2.35 per 1,000 central line-days for central line-associated bloodstream infections, and 0.87 per 1,000 ventilator-days for ventilator-associated pneumonia. Gram-negative bacilli accounted for the largest proportion of HAI pathogens, followed by gram-positive cocci and Candida spp.. Antimicrobial resistance remains a major concern, with high methicillin resistance in Staphylococcus aureus and carbapenem resistance in Acinetobacter and Pseudomonas. Findings from the KONIS, including its periodic official reports and peer-reviewed publications, have informed hospital infection control practices and national strategies, and have provided solid evidence for targeted interventions. The KONIS has been incorporating risk-adjusted indicators, such as the standardized infection ratio (SIR) and standardized utilization ratio (SUR), while enhancing data reliability and surveillance efficiency by strengthening auditing, continuous training, and digital automation of data collection. Over the past two decades, the KONIS-ICU has been established as the cornerstone of the national infection surveillance in Korea. The continued leadership of the KOSHIC is crucial for maintaining the sustainability of the KONIS-ICU, advancing its data quality, and aligning it with global surveillance initiatives.
