title: Health Care-Associated Infection Outbreak Investigations in Outpatient Settings, Los Angeles County, California, USA, 2000-2012.
abstract: Health care services are increasingly delivered in outpatient settings. However, infection control oversight in outpatient settings to ensure patient safety has not improved and literature quantifying reported health care-associated infection outbreaks in outpatient settings is scarce. The objective of this analysis was to characterize investigations of suspected and confirmed outbreaks in outpatient settings in Los Angeles County, California, USA, reported during 2000-2012, by using internal logs; publications; records; and correspondence of outbreak investigations by characteristics of the setting, number, and type of infection control breaches found during investigations, outcomes of cases, and public health responses. Twenty-eight investigations met the inclusion criteria. Investigations occurred frequently, in diverse settings, and required substantial public health resources. Most outpatient settings investigated had >1 infection control breach. Lapses in infection control were suspected to be the outbreak source for 16 of the reviewed investigations.
authors.forename: Kelsey
authors.initials: K
authors.lastname: OYong
authors.forename: Laura
authors.initials: L
authors.lastname: Coelho
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Bancroft
authors.forename: Dawn
authors.initials: D
authors.lastname: Terashita
mesh_terms: D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D003153:Community Health Services / Q000706:statistics & numerical data*; D003428:Cross Infection / Q000453:epidemiology*; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D006801:Humans; D017053:Infection Control / Q000706:statistics & numerical data; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000706:statistics & numerical data*; D015141:Los Angeles / Q000453:epidemiology
keywords: California; Los Angeles County; United States; ambulatory care facilities; bacteria; communicable disease control; disease outbreaks; fungi; health care; infection control; outbreak investigations; outpatient settings; parasites; viruses