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How Outbreaks Can Contribute to Prevention of Nosocomial Infection: Analysis of 1,022 Outbreaks

Published online by Cambridge University Press:  21 June 2016

Petra Gastmeier ,
Sabine Stamm-Balderjahn ,
Sonja Hansen ,
Frauke Nitzschke-Tiemann ,
Irina Zuschneid ,
Katrin Groneberg  and
Henning Rüden
Petra Gastmeier*
Affiliation:
Institute of Medical Microbiology and Hospital Epidemiology, Medical School Hannover, Hannover, Germany
Sabine Stamm-Balderjahn
Affiliation:
Institute of Hygiene and Environmental Medicine, Charité – University Medicine, Berlin, Germany
Sonja Hansen
Affiliation:
Institute of Hygiene and Environmental Medicine, Charité – University Medicine, Berlin, Germany
Frauke Nitzschke-Tiemann
Affiliation:
Institute of Hygiene and Environmental Medicine, Charité – University Medicine, Berlin, Germany
Irina Zuschneid
Affiliation:
Institute of Hygiene and Environmental Medicine, Charité – University Medicine, Berlin, Germany
Katrin Groneberg
Affiliation:
Institute of Hygiene and Environmental Medicine, Charité – University Medicine, Berlin, Germany
Henning Rüden
Affiliation:
Institute of Hygiene and Environmental Medicine, Charité – University Medicine, Berlin, Germany
*
Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625 Hannover, GermanyGastmeier.Petra@mh-hannover.de
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Abstract

Objective:

To describe the epidemiology of nosocomial outbreaks published in the scientific literature.

Design:

Descriptive information was obtained from a sample of 1,022 published nosocomial outbreaks from 1966 to 2002.

Methods:

Published nosocomial outbreaks of the most important nosocomial pathogens were included in the database. A structured questionnaire was devised to extract information in a systematic manner on nosocomial outbreaks published in the literature. The following items were used: the reference, type of study (case reports or studies applying epidemiologic or fingerprinting methods), type of microorganism, setting, patients and personnel involved, type of infection, source of infection, mode of transmission, risk factors identified, and preventive measures applied.

Results:

Bloodstream infection was the most frequently identified type of infection (37.0%), followed by gastrointestinal infection (28.5%) and pneumonia (22.9%). In 37% of the outbreaks, the authors were not able to identify the sources. The most frequent sources were patients (25.7%), followed by medical equipment or devices (11.9%), the environment (11.6%), and the staff (10.9%). The mode of transmission remained unclear in 28.3% of the outbreaks. Transmission was by contact in 45.3%, by invasive technique in 16.1%, and through the air in 15.0%. The percentage of outbreaks investigated by case-control studies or cohort studies over the years was small (21% and 9%, respectively, for the whole time period).

Conclusion:

Outbreak reports in the literature are a valuable resource and should be used for educational purposes as well as for preparing outbreak investigations.

Type
Orginal Articles
Information
Infection Control & Hospital Epidemiology , Volume 26 , Issue 4 , April 2005 , pp. 357 - 361
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

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References

1.Jarvis, W, Zaza, S. Investigation of outbreaks. In: Mayhall, C, ed. Hospital Epidemiology and Infection Control. Philadelphia: Lippincott Williams & Wilkins; 1998:111–120.Google Scholar
2.National Nosocomial Infections Surveillance (NNIS) System. National Nosocomial Infections Surveillance (NNIS) System report: data summary from January 1992 to June 2002, issued August 2002. Am J Infect Control 2002;30:458–475.CrossRefGoogle Scholar
3.Nationales Referenzzentrum für die Surveillance von nosokomialen Infektionen. Krankenhaus-lnfektions-Surveillance System. Berlin: Nationales Referenzzentrum für die Surveillance von nosokomialen Infektionen; 2004. Available at www.nrz-hygiene.de. Accessed January 30,2004.Google Scholar
4.Gastmeier, P, Kampf, G, Wischnewski, N, et al.Prevalence of nosocomial infections in representatively selected German hospitals. J Hosp Infect 1998;38:37–49.CrossRefGoogle ScholarPubMed
5.Richards, C, Jarvis, W. Lessons from recent nosocomial epidemics. Curr Opin Infect Dis 1999;12:327–334.CrossRefGoogle ScholarPubMed
6.Wendt, C, Herwaldt, LA. Epidemics: identification and management. In: Wenzel, RP, ed. Prevention and Control of Nosocomial Infections. Baltimore: Williams and Wilkins; 1997:175–213.Google Scholar
7.Outbreak Worldwide Database [database online]. Norderstedt, Germany: Schülke & Mayr GmbH, Robert-Koch-Straße; 2003. Available at www.outbreak-database.com/. Accessed January 30, 2004.Google Scholar