Service d'Hygiène Hospitalière, Epidémiologie et Prévention, Hôpital Edouard Herriot, Hospices Civils de Lyon, 5 place d'Arsonval, Lyon, France.
Med Mycol. 2011 Apr;49 Suppl 1:S24-9. doi: 10.3109/13693786.2010.509335. Epub 2010 Sep 6.
Discrimination between nosocomial and community infections is important for investigation and prevention. Nosocomial and hospital-acquired infections require appropriate hospital control measures to avert additional cases. Nosocomial infections (NI) occur during hospitalization or are caused by microorganisms acquired during hospital stay. Such infections should not be evident when patients are admitted to the hospital. Furthermore, the definition of NI is based on epidemiological criteria, such as the time lapse between admission and onset, or microbiological criteria. This definition might be difficult to apply to invasive aspergillosis (IA) which often afflicts patients with severe immunosuppression or transplantation. Identification of the source may be difficult which could arise outside or inside the hospital. Another significant issue is the lack of valid and reproducible data on the incubation period. The incubation duration of IA is influenced by different individual or environmental determinants, including the severity of immunosuppression and air quality. The criteria of causality are also a means of discussing the contribution of hospital vs. community determinants of IA. The definition of nosocomial IA remains difficult. A better understanding of early events related to IA onset will help to prevent this disease for which the prognosis remains negative.
医院感染和社区感染的鉴别对于调查和预防非常重要。医院感染和医院获得性感染需要采取适当的医院控制措施，以避免出现更多病例。医院感染（NI）发生在住院期间或由住院期间获得的微生物引起。当患者入院时，这些感染不应明显存在。此外，NI 的定义基于流行病学标准，例如入院和发病之间的时间间隔，或微生物学标准。对于侵袭性曲霉菌病（IA），这一定义可能难以应用，因为侵袭性曲霉菌病常影响严重免疫抑制或移植的患者。确定来源可能很困难，因为它可能发生在医院内外。另一个重要问题是缺乏关于潜伏期的有效和可重复的数据。IA 的潜伏期受不同个体或环境决定因素的影响，包括免疫抑制的严重程度和空气质量。因果关系的标准也是讨论 IA 的医院和社区决定因素的贡献的一种手段。医院获得性 IA 的定义仍然很困难。更好地了解与 IA 发病相关的早期事件将有助于预防这种预后仍然为负面的疾病。
