Gottsch J D, Froggatt J W, Smith D M, Dwyer D M, Borenstein P, Karanfil L V, Vitale S, Goldberg M F
Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287-9235, USA.
Ophthalmic Epidemiol. 1999 Mar;6(1):29-39. doi: 10.1076/opep.6.1.29.1564.
To determine if an ongoing infection control program is associated with a reduction in rates of nosocomial outbreaks of epidemic keratoconjunctivitis (EKC) and outbreak morbidity from nosocomial EKC in a large teaching eye institute.
The number of nosocomial EKC outbreaks, the number of affected patients, and the total number of patient visits were collected for each year between 1984 and 1997. An infection control program was implemented in 1992. The program included specified methods of patient screening and isolation, handwashing, instrument disinfection, medication distribution, and furlough of infected employees. The program included two levels of intensity of infection control measures, for non-outbreak and outbreak conditions. We compared rates per 100,000 patient visits of nosocomial outbreaks of EKC and affected patients for the 6-year period after the program was implemented, 1992-1997, with corresponding rates for 1984-1991.
One, to three nosocomial outbreaks of EKC occurred annually in the period 1984-1991. After the implementation of the infection control program, no nosocomial outbreaks occurred in three of six years studied. In the pre-infection control years 1984-1991, there were 3.89 outbreaks and 54.09 affected patients per 100,000 visits, respectively. For the post-infection control years 1992-1997, the corresponding rates were 0.54 outbreaks and 5.66 affected patients per 100,000 patient visits. Rates for both outbreaks and affected patients were significantly lower for the post-implementation period (p < 0.005 and p < 0.0005, respectively).
An ongoing infection control program was associated with decreased rates of nosocomial EKC outbreaks and outbreak morbidity from nosocomial EKC in our institute. Although several reports have described infection control measures that terminated individual outbreaks of nosocomial EKC, this study demonstrates that an ongoing infection control program may preemptively reduce nosocomial EKC outbreaks.
确定在一家大型教学眼科机构中，持续实施的感染控制计划是否与流行性角结膜炎（EKC）医院感染暴发率的降低以及医院感染性EKC的暴发发病率的降低相关。
收集了1984年至1997年每年医院感染性EKC暴发的次数、受影响患者的数量以及患者就诊总数。1992年实施了一项感染控制计划。该计划包括患者筛查和隔离、洗手、器械消毒、药物分发以及感染员工休假的特定方法。该计划包括针对非暴发和暴发情况的两级感染控制措施强度。我们比较了1992 - 1997年该计划实施后的6年期间，每100,000次患者就诊中EKC医院感染暴发和受影响患者的发生率，与1984 - 1991年的相应发生率。
1984 - 1991年期间，每年发生1至3起医院感染性EKC暴发。实施感染控制计划后，在研究的6年中有3年未发生医院感染暴发。在感染控制前的1984 - 1991年，每100,000次就诊分别有3.89起暴发和54.09名受影响患者。对于感染控制后的1992 - 1997年，相应的发生率分别为每100,000次患者就诊0.54起暴发和5.66名受影响患者。实施后期间暴发和受影响患者的发生率均显著降低（分别为p < 0.005和p < 0.0005）。
在我们机构中，持续实施的感染控制计划与医院感染性EKC暴发率以及医院感染性EKC的暴发发病率的降低相关。尽管有几份报告描述了终止医院感染性EKC个别暴发的感染控制措施，但本研究表明，持续实施的感染控制计划可能会预防性地减少医院感染性EKC暴发。
