J. Clin. Microbiol., Jan. 2002, p. 1-4.
INTRODUCTION
We face an exciting future in modern health care. Advances have markedly prolonged the human life span, but accompanied by this increased life expectancy is the increasing challenge of controlling health care-associated infectious diseases. In order to manage this problem, timely and comprehensive surveillance is required so as to first detect and then intervene against these infections. The scope of surveillance activities can be either focused (by disease or nursing unit) or comprehensive (system-wide). It can also be passive (detection by fortunate chance observation) or active (planned monitoring of multiple data and infection event sources). The clinical microbiology laboratory has the information drawn from cultures performed for potentially infected patients, and cost-effective use of this data offers great potential for early detection of health care-associated infectious diseases. Standardized practices for infection control arose in England early in the 19th century, when segregation of smallpox and fever patients was formalized (29). Later, when statistical analysis demonstrating the benefit of infection control practices was applied to an outbreak of typhus, it showed that a 10-fold reduction in nosocomial cases and a 42-fold decrease in associated deaths resulted from adherence to specific practices for contagious patients (16). Microbiologists began to play an important role in infection control, documenting microbial contamination of the operating room environment that resulted from surgeons? carrying on normal conversations, leading to the standard practice of wearing masks during surgery (28). Modern hospital epidemiology only began in the mid-1960s (15), and since that time the clinical microbiology laboratory has progressively demonstrated the critical roles it can serve for ongoing management and control of health careassociated
infectious diseases.
Lance R. Peterson and Stephen E. Brossette