Hostname: page-component-848d4c4894-nr4z6 Total loading time: 0 Render date: 2024-05-20T12:30:12.924Z Has data issue: false hasContentIssue false

Occult Nosocomial Infections

Published online by Cambridge University Press:  02 January 2015

Christiane Petignat
Centre Hospitalier Universitaire Vaudois, Division autonome de médecine préventive hospitalière, Lausanne, Switzerland
Dominique S. Blanc
Centre Hospitalier Universitaire Vaudois, Division autonome de médecine préventive hospitalière, Lausanne, Switzerland
Patrick Francioli*
Centre Hospitalier Universitaire Vaudois, Division autonome de médecine préventive hospitalière, Lausanne, Switzerland
Centre Hospitalier Universitaire Vaudois, Division autonome de médecine préventive hospitalière, CH-1011 Lausanne, Switzerland; e-mail,


Even with a good surveillance program, nosocomial infections may be not recognized because of several reasons: absence of symptoms or prolonged incubation period (eg, viral bloodborne infections, tuberculosis); problems with the microbiological diagnosis, because adequate specimens may be difficult to obtain or special methods should be used (eg, fungal infections, virus, new agents); shorter hospital stays (eg, surgical-site infections); difficulty in distinguishing between nosocomial and community-acquired infections (eg, influenza); and failure to detect clinically relevant colonization (eg, multiresistant microorganisms). Because of the important potential consequences of occult nosocomial infections, specific surveillance programs should be designed to address these problems.

From the Fifth International Conference on the Prevention of Infection
Copyright © The Society for Healthcare Epidemiology of America 1998

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


1.Geberding, JL. The infected health care provider. N Engl J Med 1996;334:594595.Google Scholar
2.Bronowicki, JP, Venard, V, Botte, C, Monhoven, N, Gastin, I, Chome, L, et al.Patient-to-patient transmission of hepatitis C virus during colonoscopy. N Engl J Med 1998;337:237240.Google Scholar
3.Favero, MS, Pugliese, G. Infections transmitted by endoscopy: an international problem. Am J Infect Control 1996;24:343345.Google Scholar
4.Heptonstall, JE. Transmission of hepatitis B to patients from four infected surgeons without hepatitis B e antigen. N Engl J Med 1997;336: 178184.Google Scholar
5.Olmsted, RN. What is the risk of acquiring hepatitis C for health care workers and what are the recommendations for prophylaxis and follow-up after occupational exposure to hepatitis C virus ? Am J Infect Control 1996;24:411415.Google Scholar
6.Esteban, JI, Gomez, J, Martell, M, Cabot, B, Quer, J, Camps, J, et al.Transmission of hepatitis C virus by a cardiac surgeon. N Engl J Med 1996;334:555560.Google Scholar
7.Olmer, M, Bouchouareb, D, Zandotti, C, de Micco, C, de Lamballerie, X. Transmission of the hepatitis C virus in an hemodialysis unit: evidence for nosocomial infection. Clinical Nephrology 1996;47:263270.Google Scholar
8.Robert, LM, Chamberland, ME, Cleveland, JL, Marcus, R, Gooch, BF, Srivastava, PU, et al.Investigations of patients of health care workers infected with HIV. Ann Intern Med 1995;122:653657.Google Scholar
9.Dooley, SW, Villarino, ME, Lawrence, M, Salinas, L, Amil, S, Rullan, JV, et al.Nosocomial transmission of tuberculosis in a hospital unit for HIV- infected patients. JAMA 1992;267:26322634.Google Scholar
10.Kenyon, TA, Ridzon, R, Luskin-Hawk, R, Schultz, C, Paul, WS, Valway, SE, et al.A nosocomial outbreak of multidrug-resistant tuberculosis. Ann Intern Med 1998;127:3236.Google Scholar
11.Guerrero, A, Cobo, J, Fortun, J, Navas, E, Quereda, C, Asensio, A, et al.Nosocomial transmission of Mycobacterium bovisresistant to 11 drugs in people with advanced HIV-1 infection. Lancet 1997;350:17381742.Google Scholar
12.Pearson, ML, Jereb, JA, Frieden, TR, Crawford, JT, Davis, BJ, Dooley, SW, et al. Nosocomial transmission of multidrug-resistant Mycobacterium tuberculosis. Ann Intern Med 1992;117:191196.Google Scholar
13.Couldwell, DL, Dore, GJ, Harkness, JL, Marriott, DJE, Cooper, DA, Edwards, R, et al.Nosocomial outbreak of tuberculosis in an outpatient HIV treatment room. AIDS 1996;10:521525.Google Scholar
14.Menzies, D, Fanning, A, Yuan, L, Fitzgerald, M. Tuberculosis among health care workers. N Engl J Med 1995;332:9298.Google Scholar
15.Blumberg, HM, Watkins, DL, Berschling, JD, Antle, A, Moore, P, White, N, et al.Preventing the nosocomial transmission of tuberculosis. Ann Intern Med 1995;122:658663.Google Scholar
16.Allan, B, Tuft, S. Transmission of Creutzfeldt-Jakob disease in corneal grafts: observing the exclusion criteria for donated grafts should ensure the risk is small. BMJ 1997;315:15531554.Google Scholar
17.McGreevy Steelman, V. Creutzfeldt-Jakob diseases: recommendations for infection control. Am J Infect Control 1994;22:312318.Google Scholar
18.Herwaldt, LA, Pottinger, JM, Carter, CD, Barr, BA, Miller, ED. Exposure workups. Infect Control Hosp Epidemiol 1997;18:850871.Google Scholar
19.Valenti, WM. Selected viruses of nosocomial importance. In: Bennett, JV, Brachman, PS, eds. Hospital Infections. 4th ed. Philadelphia, PA: Lippincott-Raven; 1998:637664.Google Scholar
20.Weigelt, JA, Dryer, D, Haley, RW. The necessity and efficiency of wound surveillance after discharge. Arch Surg 1992;127:7782.Google Scholar
21.Bean, B, Rhane, FS, Hughes, RS, Weiler, MD, Peterson, LR, Gerding, DN. Influenza B: hospital activity during a community epidemic. Diagn Microbiol Infect Dis 1983;1:177183.Google Scholar
22.Holladay, RC, Campbell, GDJ. Nosocomial viral pneumonia in the intensive care unit. Clinics in Chest Medicine 1995;16:121133.Google Scholar
23.Centers for Disease Control and Prevention. Guidelines for prevention of nosocomial pneumonia. MMWR 1997;46:179.Google Scholar
24.Ta, AC, Stout, JE, Yu, VL, Wagener, MM. Comparison of culture methods for monitoring Legionella species in hospital potable water systems and recommendations for standardization of such methods. J Clin Microbiol 1995;33:21182123.Google Scholar