The molecular epidemiology of nosocomial infection: Past, present and future

One of the most daunting concerns in modern health care today is the issue of nosocomial infection and associated efforts to monitor and control it. Over the years, the epidemiological analysis of nosocomial infection has undergone a remarkable evolutionary metamorphosis. While initially relying on purely phenotypic characterization, recent years have seen a variety of approaches to epidemiological analysis emerge from developments in molecular biology, resulting in the advent of what is conventionally termed 'molecular epidemiology'. The chronology of that process is reviewed here, considering the advantages and disadvantages of the various typing methods, concentrating especially on the most widely used current approaches. In addition, issues related to when one should use molecular typing, specific approaches to use, application scenarios, and possible future developments are also addressed. (C) 2000 Lippincott Williams and Wilkins.