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On 5 May 2017, the European Centre for Disease Prevention and Control (ECDC) published its updated protocol for surveillance of healthcare-associated infections (HAIs) and prevention indicators in European intensive care units (ICUs) [1]. The ECDC’s Healthcare-Associated Infections surveillance Network (HAI-Net) has been coordinating European surveillance of HAIs in ICUs since 2008 with participation of 15 countries and 1365 ICUs in 2015 [2]. The methodology was originally developed by the Hospitals in Europe Link for Infection Control through Surveillance (HELICS) project in 2000–2002 [3] and adopted by ECDC in 2010. A revision of the first protocol was agreed at consensus expert meetings in 2013–2015. The objective of the ECDC surveillance protocol is the standardisation of case definitions, data collection and reporting procedures for hospitals participating in national or regional surveillance of HAIs in ICUs across Europe in order to facilitate the collection of comparable epidemiological data as a basis for interventions and the communication and exchange of experience of national surveillance systems. The case definitions of HAIs aim to accommodate differences, across Europe, in diagnostic practices such as taking microbiological samples for the diagnosis of HAIs. The minimal requirement for participation in surveillance of HAIs in ICUs is surveillance of bloodstream infections (BSIs) and pneumonia (PN). Reporting of urinary tract infections (UTIs) and catheter-related infections (CRIs) is optional. The data are collected by the national surveillance systems and submitted annually to ECDC. The results are published on the ECDC website [2]. A software application, HelicsWin. Net, is available free-of-charge for entry of HAI surveillance data (https ://ecdc.europ a.eu/en/publi catio ns-data/ helic swinn et-hwn). The latest update of the ECDC protocol was triggered by the unexplained, large variation in the prevalence of HAIs among European countries reported by the ECDC point prevalence survey of HAIs and antimicrobial use in European acute care hospitals 2011–2012. Structure and process indicators for infection prevention and control and antimicrobial stewardship (Table 1), as well as a new variable on the outcome of the HAI were included in the latest version of the surveillance protocol. These modifications were developed by ECDC and HAI-Net ICU experts and agreed during an HAI-Net ICU meeting in February 2015. The ECDC case definitions applied for surveillance of HAIs in European ICUs are presented in Table 1a in the supplementary material. The case definition for BSI addresses both primary and secondary BSIs. A definition for CRI establishes the microbiological criteria for assignment of the catheter as the origin of the BSI. When CRIs are not specifically reported, BSIs for which the same microorganism was cultured from the catheter or when symptoms improved within 48 h after removal of the catheter are reported as BSIs with origin central venous catheter (CVC). In this way, it is possible to assess the burden of BSIs linked to catheters in ICUs with different local practices for microbiological confirmation through culture of the catheter *Correspondence: [email protected] 1 European Centre for Disease Prevention and Control, Gustav III:s boulevard 40, 169 73 Solna, Sweden Full author information is available at the end of the article