OYong Kelsey, Coelho Laura, Bancroft Elizabeth, Terashita Dawn
Emerg Infect Dis. 2015 Aug;21(8):1317-21. doi: 10.3201/eid2108.141251.
Health care services are increasingly delivered in outpatient settings. However, infection control oversight in outpatient settings to ensure patient safety has not improved and literature quantifying reported health care-associated infection outbreaks in outpatient settings is scarce. The objective of this analysis was to characterize investigations of suspected and confirmed outbreaks in outpatient settings in Los Angeles County, California, USA, reported during 2000-2012, by using internal logs; publications; records; and correspondence of outbreak investigations by characteristics of the setting, number, and type of infection control breaches found during investigations, outcomes of cases, and public health responses. Twenty-eight investigations met the inclusion criteria. Investigations occurred frequently, in diverse settings, and required substantial public health resources. Most outpatient settings investigated had >1 infection control breach. Lapses in infection control were suspected to be the outbreak source for 16 of the reviewed investigations.
医疗保健服务越来越多地在门诊环境中提供。然而，门诊环境中的感染控制监督以确保患者安全并未得到改善，并且量化门诊环境中报告的医疗保健相关感染暴发的文献很少。本分析的目的是利用内部日志、出版物、记录以及按调查期间发现的感染控制违规的环境特征、数量和类型、病例结果及公共卫生应对措施对应急调查的通信，对2000年至2012年期间美国加利福尼亚州洛杉矶县门诊环境中疑似和确诊暴发的调查进行特征描述。28项调查符合纳入标准。调查频繁发生，涉及多种环境，并且需要大量公共卫生资源。大多数接受调查的门诊环境存在>1次感染控制违规。在所审查的16项调查中，怀疑感染控制失误是暴发源。
