Epidemiologic methods for the prevention of nosocomial infections

There is an ongoing controversy in Europe about the benefits and limitations of epidemiologic methods for the prevention and control of hospital-acquired infections. Hospital epidemiology, aimed at measuring the necessity, or effect, of preventive strategies for nosocomial infection control, is still an unknown field in many European institutions. The conceptual framework presented here is not intended as a complete review of modern hospital epidemiology, but should be considered rather a viewpoint which tries to bridge the gap between microbiology-based hospital hygiene and hospital epidemiology in Europe. The explanatory power and limitations of descriptive, analytical and interventional epidemiology are described. Based on the assumption that nosocomial infections have causal and preventive factors that can be identified through systematic investigation, epidemiologic methods add important knowledge to reduce hospital-acquired infections.