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Recently, a paper published by CMR reviewed detailed information about this topic——“ hospital epidemiology and infection control in acute-care settings”. It is really helpful and useful. The "introduction" was shown as follows:
The Centers for Disease Control and Prevention (CDC) defines health care-associated infections (HAIs) as infections acquired while in the health care setting (e.g., inpatient hospital admission, hemodialysis unit, or same-day surgery), with a lack of evidence that the infection was present or incubating at the time of entry into the health care setting (139). These definitions need to respond to a changing medical environment. Modern medical care has become more invasive and therefore associated with a greater risk of infectious complications. An aging population, the AIDS epidemic, the growth of chemotherapeutic options for cancer treatment, and a growing transplant population have expanded the population at an increased risk for infection as a consequence of interactions with the health care system. Both surgical care and medical care that are increasingly complex and invasive are being provided in non-acute-care settings, making the definition of a health care setting more problematic. Finally, patients move freely within sometimes loosely defined elements of the health care system: between long-term care or rehabilitation facilities, to acute-care facilities, to free-standing surgical care providers. In 1980, the Study on the Efficacy of Nosocomial Infection Control (SENIC) demonstrated that surveillance for nosocomial infections and infection control practices that included trained professionals could prevent HAIs (122). As a result, an important role developed for hospital epidemiologists and infection control practitioners (298). As medical care has become more complex, antimicrobial resistance and HAIs have increased, as have their attributable morbidity and mortality (362). Additionally, HAIs increase hospital lengths of stay and health care expenditures (247). In response to patient risks and growing costs, in 2008 the Centers for Medicare and Medicaid Services (CMS) implemented a strategy of withholding reimbursement for certain HAIs such as catheter-associated urinary tract infections (CA-UTIs) and central line-associated bloodstream infections (CLABSIs) (336). Now more than ever, institution-specific surveillance driven by hospital epidemiologists and infection preventionists (IPs) is needed in order to enact early detection and prevention strategies to curtail HAIs. This review is intended for general internists and infectious diseases physicians and provides a general overview of hospital epidemiology and infection control in acute-care settings. This review summarizes some of the challenges and opportunities faced by the health care epidemiology community. We discuss HAIs in the broadest sense to include all health care-associated infections, communicable diseases, and multidrug-resistant (MDR) and epidemiologically significant organisms. |