《BobNosoc翻译.ppt

Surveillance and Descriptive Epidemiology for Hospital-Acquired Infections 院内感染的监测与描述流行病学 Robert E. Fontaine, MD, MSc Division of International Health Centers for Disease Control and Prevention Atlanta, GA, USA Epidemiologic Triad 流行病学三要素Organizing your epidemiologic thinking组织流行病学思维 Many special host factors modify the epidemiology of hospital infections 许多特殊的宿主因素影响医院感染流行病学 Exposures to infectious agents differ greatly from the community.感染性病原体的暴露与社区明显不同 The hospital microenvironment creates a special opportunities for contamination and transmission.医院的小环境为污染和传播创造特别的机会 The hospital has special transmission pathways.医院存在特殊传播途径 The host-agent interaction results in 3 states.宿主-病原相互作用的3种状态 What is a case definition? 什么是病例定义? A set of standard criteria 一套标准 Used to decide if a person has an infection 用于确定是否感染 Assures that differences in health statistics are real 保证卫生统计差异是真实的 Varies with the purpose 根据目的不同而有所变化 Why use a case definition?为什么使用病例定义? Doctors, nurses, laboratories, and others report notifiable events 医生、护士、实验室和其他人员报告法定报告事件 Produces extraneous variability in these data 资料产生外在的变异 Need to minimize this variability to:需要将这种变异最小化以 Monitor trends 监视趋势 Evaluate the effectiveness of intervention activities 评价干预措施的效果 Compare areas 进行地区间的比较 Comparisons must reflect changes or differences in the disease. 比较必须反应疾病本身的变化和差异 Disease Identifiers: 疾病识别指标： Symptomatology 症状 Signs (Physical examination) 体征（体检） Clinical evaluations (EKG, EEG, etc.)临床评价（心电图、脑电图等） Lack of compatibility with other diseases 排除其他疾病 Response to treatment 治疗反应 Laboratory tests (virus isolation, blood sugar, etc.) 实验室检测（病毒分离、血糖等） Epidemiologic criteria流行病学标准 Time 时间 Place 地点 Person 人 Associations with risk factors 与危险因素的关系 Host factors (underlying illness) 宿主因素（基础疾病） The case definition may have levels of certainty. 病例定义可按确定程度分多个水平 Confirmed 确诊病例 Probable 临床病例 Possible 可能病例 Suspect 疑似病例 Infectious gastroenteritis: Example case definition 感染