The evolving art and science of hospital epidemiology.
The evolving art and science of hospital epidemiology.
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医院流行病学不断发展的艺术和科学。
DOI：
10.1093/infdis/153.3.462
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发表时间：
1986
期刊：
影响因子：
--
通讯作者：
Wenzel,RP
中科院分区：
文献类型：
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作者：
Wenzel,RP
医院感染是一门新兴的医学学科。尽管几个世纪以来，人们对医疗机构中患者的命运有着重要的认识和兴趣[1，2]，但直到最近几十年，医院感染领域才被普遍接受。在现代医院流行病学和感染控制发展中起作用的重要力量包括在20世纪40年代认识到需要控制医院中的传染病集群[3]，在20世纪50年代由金黄色葡萄球菌引起的医院感染的广泛出现[4]，在1970年的主要开始，疾病控制中心的疾病监测和控制[5]，以及随后的医院认证联合委员会（JCAH）的机构要求[6]。从1970年到1985年，许多研究已经证实住院期间感染的发病率为5%-10%[7，8]，血液医院感染的归因死亡率高达r '，25%[9-12]，以及与各种解剖部位的医院感染直接相关的平均5到10天的住院时间[13-16]。很明显，即使是最保守的估计，美国每年发生的200万至400万例医院获得性感染的后果也是导致死亡的主要原因和30亿至100亿美元的经济负担[17，18]。一个新的兴趣在医院感染的结果已经遵循了介绍
The study of hospital-acquired infections is a new discipline in the young science of medicine. Although there have been important recognition and interest for centuries in the fates of patients housed in institutions for medical care [1, 2], it is only in recent decades that the field of nosocomial infection as such has been generally accepted. The important forces operative in the development of modern hospital epidemiology and infection control included the recognition of the need to control clusters of diarrheal diseases in hospitals in the 1940s [3], the widespread emergence of nosocomial infections caused by Staphylococcus aureus in the 1950s [4], the major initiation, in 1970, of the Centers for Disease Control for surveillance and control of disease [5], and subsequent institutional requirements of the Joint Commission for the Accreditation of Hospitals (JCAH)[6]. From 1970 to 1985, a number of studies have confirmed the 5%-10% attack rate of infec-tions during hospitalization [7, 8], the high, r', 25%, attributable mortality for nosocomial infections of the bloodstream [9-12], and the average five-to 10-day added hospital stay directly related to nosocomial infections at various anatomical sites [13-16]. It is clear that even by the most conservative estimates, the consequences of the two to four million hospital-acquired infections occurring in the United States annually represent a leading cause of death and an economic burden of three to ten billion dol-lars [17, 18]. A renewed interest in the outcome of nosocomial infections has followed the introduction