Goodman R A, Solomon S L
Epidemiology Program Office, Centers for Disease Control, Atlanta, GA 30333.
JAMA. 1991 May 8;265(18):2377-81.
Increased provision of health care in outpatient settings and concerns about occupational transmission of infections have focused attention on the risk of transmission of infectious diseases in ambulatory health care settings. In contrast to inpatient nosocomial infections, infections transmitted in outpatient settings are neither systematically monitored nor likely to be detected by routine qi surveillance. To better define the spectrum of such events, we reviewed the literature to identify cases and clusters of infections associated with outpatient health care. In this review, we identified and epidemiologically characterized 53 such reports that occurred from 1961 through 1990. Transmission occurred in general medical offices, clinics, and emergency departments (23); ophthalmologists' offices and clinics (11); dental offices (13); and alternative-care settings (six). Our findings suggest that inpatient infection-control practices should be extended to outpatient health care settings by assigning specific responsibility for infection control and by adapting surveillance methods and prevention measures.
门诊医疗服务的增加以及对职业性感染传播的担忧，使人们将注意力集中在门诊医疗环境中传染病传播的风险上。与住院患者的医院感染不同，门诊环境中传播的感染既没有得到系统监测，也不太可能通过常规监测发现。为了更好地界定此类事件的范围，我们查阅了文献，以确定与门诊医疗相关的感染病例和聚集性感染。在本次综述中，我们确定并从流行病学角度描述了1961年至1990年间发生的53份此类报告。传播发生在综合内科诊所、急诊室（23起）；眼科诊所（11起）；牙科诊所（13起）；以及替代医疗场所（6起）。我们的研究结果表明，应通过指定感染控制的具体职责以及调整监测方法和预防措施，将住院患者的感染控制措施扩展到门诊医疗环境。
