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Pseudoepidemics in hospital

R A Weinstein, W E Stamm

    Lancet (London, England)
    |October 22, 1977
    PubMed
    Summary
    This summary is machine-generated.

    A significant portion of investigated nosocomial epidemics were false outbreaks due to errors. Improving laboratory quality control and clinician collaboration can prevent these pseudoepidemics.

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    Area of Science:

    • Infectious Disease Epidemiology
    • Clinical Microbiology
    • Healthcare Quality Improvement

    Background:

    • Nosocomial epidemics pose a significant threat to patient safety.
    • Accurate identification of outbreaks is crucial for effective public health interventions.
    • Previous investigations have not fully quantified the occurrence of false outbreaks.

    Purpose of the Study:

    • To determine the proportion of investigated nosocomial epidemics that were false outbreaks.
    • To identify the common causes of false outbreaks (pseudoepidemics).
    • To recommend strategies for preventing pseudoepidemics.

    Main Methods:

    • Retrospective analysis of 181 nosocomial epidemics investigated by the Center for Disease Control between 1956 and 1975.
    • On-site investigations to identify the root causes of reported outbreaks.

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  • Categorization of causes into specimen processing errors, surveillance artefacts, and clinical misdiagnosis.

    • Main Results:

    • 20 (11%) of 181 investigated nosocomial epidemics were identified as false outbreaks.
    • Specimen processing errors were the most frequent cause (11 cases), including contamination and misidentification.
    • Surveillance artefacts accounted for 6 cases, and clinical misdiagnosis for 3 cases.

    Conclusions:

    • Pseudoepidemics are a notable issue in nosocomial outbreak investigations.
    • Enhancing laboratory quality control and interdisciplinary communication is essential for prevention.
    • Systematic review of incongruous laboratory results can help avoid misclassification of outbreaks.