Gastmeier Petra, Stamm-Balderjahn Sabine, Hansen Sonja, Nitzschke-Tiemann Frauke, Zuschneid Irina, Groneberg Katrin, Rüden Henning
Institute of Medical Microbiology and Hospital Epidemiology, Medical School Hannover, Hannover, Germany.
Infect Control Hosp Epidemiol. 2005 Apr;26(4):357-61. doi: 10.1086/502552.
To describe the epidemiology of nosocomial outbreaks published in the scientific literature.
Descriptive information was obtained from a sample of 1,022 published nosocomial outbreaks from 1966 to 2002.
Published nosocomial outbreaks of the most important nosocomial pathogens were included in the database. A structured questionnaire was devised to extract information in a systematic manner on nosocomial outbreaks published in the literature. The following items were used: the reference, type of study (case reports or studies applying epidemiologic or fingerprinting methods), type of microorganism, setting, patients and personnel involved, type of infection, source of infection, mode of transmission, risk factors identified, and preventive measures applied.
Bloodstream infection was the most frequently identified type of infection (37.0%), followed by gastrointestinal infection (28.5%) and pneumonia (22.9%). In 37% of the outbreaks, the authors were not able to identify the sources. The most frequent sources were patients (25.7%), followed by medical equipment or devices (11.9%), the environment (11.6%), and the staff (10.9%). The mode of transmission remained unclear in 28.3% of the outbreaks. Transmission was by contact in 45.3%, by invasive technique in 16.1%, and through the air in 15.0%. The percentage of outbreaks investigated by case-control studies or cohort studies over the years was small (21% and 9%, respectively, for the whole time period).
Outbreak reports in the literature are a valuable resource and should be used for educational purposes as well as for preparing outbreak investigations.
描述科学文献中发表的医院感染暴发的流行病学特征。
从1966年至2002年发表的1022例医院感染暴发样本中获取描述性信息。
将已发表的最重要医院感染病原体的暴发纳入数据库。设计了一份结构化问卷，以系统地提取文献中发表的医院感染暴发的信息。使用了以下项目：参考文献、研究类型（病例报告或应用流行病学或指纹识别方法的研究）、微生物类型、环境、涉及的患者和人员、感染类型、感染源、传播方式、确定的危险因素以及应用的预防措施。
血流感染是最常确定的感染类型（37.0%），其次是胃肠道感染（28.5%）和肺炎（22.9%）。在37%的暴发中，作者无法确定感染源。最常见的感染源是患者（25.7%），其次是医疗设备或器械（11.9%）、环境（11.6%）和工作人员（10.9%）。在28.3%的暴发中，传播方式仍不清楚。通过接触传播的占45.3%，通过侵入性技术传播的占16.1%，通过空气传播的占15.0%。多年来通过病例对照研究或队列研究调查的暴发百分比很小（整个时间段分别为21%和9%）。
文献中的暴发报告是一种宝贵的资源，应将其用于教育目的以及准备暴发调查。
