Hunting Health Care-Associated Infections from the Clinical Microbiology Laboratory: Passive, Active, and Virtual Surveillance

Abstract

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 care-associated infectious diseases.