Le Coutour X, Grandbastien B
Service d'Hygiène, CHU, Caen.
Rev Epidemiol Sante Publique. 1994;42(5):399-407.
The risks of hospital-acquired infection were, for many years, not seriously considered. However, current conditions increase risk, and the intense media and legal interest have led to the issue becoming a major medical concern. Hospital-acquired infections can be considered from four angles: the clinical dimension is the most obvious. It involves hospitalized patients, and to an increasing degree, hospital staff; the economic impact although difficult to assess, is a largely underestimated drain on hospital budgets; the legal problems have been recently highlighted by developments in jurisprudence; finally, there are ethical considerations associated with the behaviour sometimes found among health care workers, as a consequence of workplace risks. In this article we try to define and assess the significance of the major factors. We discuss the validity of various epidemiological and economic tools, and thus highlight the role of hospital-acquired infections in the working of hospitals.
多年来,医院获得性感染的风险一直未得到认真考虑。然而,当前的状况增加了风险,媒体和法律的高度关注已使该问题成为一个主要的医学关注点。医院获得性感染可从四个角度来考量:临床层面最为明显,它涉及住院患者,并且在越来越大的程度上涉及医院工作人员;经济影响虽然难以评估,但在很大程度上是对医院预算的一种被低估的消耗;法律问题最近因法理学的发展而受到关注;最后,由于工作场所风险,存在与医护人员有时出现的行为相关的伦理考量。在本文中,我们试图界定并评估主要因素的重要性。我们讨论各种流行病学和经济工具的有效性,从而突出医院获得性感染在医院运作中的作用。