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解读2003年美国疾病控制与预防中心的牙科感染控制指南。

Looking inside the 2003 CDC dental infection control guidelines.

作者信息

Harte Jennifer A

机构信息

U.S. Air Force Dental Investigation Service, Great Lakes, Ill 60088, USA.

出版信息

J Calif Dent Assoc. 2004 Nov;32(11):919-30.

Abstract

On Dec. 19, 2003, the Centers for Disease Control and Prevention published updated infection control guidelines for dentistry. The guidelines provide comprehensive information on all aspects of dental infection control. The recommendations are designed to prevent or reduce the potential for disease transmission from patient to dental health care personnel, from dental health care personnel to patient, and from patient to patient. Most recommendations will be familiar and are already practiced routinely. This article highlights major updates and additions in the CDC guidelines and provides additional information to assist readers in applying the latest guidelines. Almost a year ago, the CDC and Prevention published updated dental infection control guidelines in a supplement to the Morbidity and Mortality Weekly Report. The Guidelines for Infection Control in Dental Health Care Settings--2003 represent a collaborative effort between leading experts in infection control from other federal agencies, public health, and hospital epidemiology and infection control. Unlike regulatory agencies such as the Occupational Safety and Health Administration, the U.S. Food and Drug Administration, or the U.S. Environmental Protection Agency, the CDC cannot mandate certain practices; it can only recommend. However, the CDC is recognized as the nation's disease prevention agency and develops a broad range of guidelines intended to improve health care and to inform clinicians and the public. As a result, many dental licensing boards adopt CDC's recommendations, or variations of them, as the infection control standard for dental practice in their states. In contrast to the 1986 and 1993 CDC dental infection control recommendations, the 2003 CDC publication includes more background information and the scientific rationale for the recommendations. Also, readers will notice that each recommendation has a rank assigned to it categorizing the recommendation on the basis of existing scientific data, theoretical rationale, and applicability (Table 1). Most recommendations will be familiar and already are practiced routinely. As with previous CDC recommendations, the guidelines are designed to prevent or reduce the potential for disease transmission from patient to dental health care personnel; from dental health care personnel to patient, and from patient to patient. The following is an overview highlighting major updates and additions in the 2003 CDC guidelines. It is not intended to be a comprehensive review. Readers can access the complete document (Figure 1) by visiting www.cdc.gov/oralhealth/ infectioncontrol.

摘要

2003年12月19日,美国疾病控制与预防中心发布了牙科感染控制指南的更新版本。这些指南提供了牙科感染控制各方面的全面信息。其建议旨在预防或减少疾病从患者传播至牙科医护人员、从牙科医护人员传播至患者以及从患者传播至患者的可能性。大多数建议是大家熟悉的,并且已经在日常工作中实施。本文重点介绍了疾病控制与预防中心指南中的主要更新内容和新增部分,并提供额外信息以帮助读者应用最新指南。大约一年前,疾病控制与预防中心在《发病率与死亡率周报》的增刊中发布了更新后的牙科感染控制指南。《2003年牙科保健机构感染控制指南》是来自其他联邦机构、公共卫生以及医院流行病学和感染控制领域的顶尖感染控制专家共同努力的成果。与职业安全与健康管理局、美国食品药品监督管理局或美国环境保护局等监管机构不同,疾病控制与预防中心不能强制规定某些做法;它只能提出建议。然而,疾病控制与预防中心被公认为美国的疾病预防机构,制定了广泛的指南以改善医疗保健并为临床医生和公众提供信息。因此,许多牙科许可委员会采用疾病控制与预防中心的建议或其变体,作为本州牙科实践的感染控制标准。与1986年和1993年疾病控制与预防中心牙科感染控制建议相比,2003年疾病控制与预防中心的出版物包含了更多背景信息以及这些建议的科学依据。此外,读者会注意到每项建议都有一个等级,该等级是根据现有科学数据、理论依据和适用性对建议进行分类的(表1)。大多数建议是大家熟悉的,并且已经在日常工作中实施。与疾病控制与预防中心以前的建议一样,这些指南旨在预防或减少疾病从患者传播至牙科医护人员、从牙科医护人员传播至患者以及从患者传播至患者的可能性。以下是对2003年疾病控制与预防中心指南主要更新内容和新增部分的概述。这并非全面综述。读者可通过访问www.cdc.gov/oralhealth/ infectioncontrol获取完整文档(图1)。

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