Nosocomial infections surveillance.

Abstract

Nosocomial infections are a major worldwide public health problem. In some countries the true magnitude of the problem may not be recognized. Nevertheless, when susceptible hospitalized individuals have contact with microbes, some will develop infections. It may be difficult for a country's health authorities to be sensitive to this situation due to the enormity of other health and social problems. But there is increasing recognition of the impact nosocomial infections have on the healthcare system, and there is increasing interest in initiating institutional infection control programs. Healthcare professionals are dedicated to do the patients no harm and, in this instance, to reduce the occurrence of nosocomial infections to the lowest possible level. Initial attempts at control and prevention included the incorporation of generic measures into patient care routines with varying degrees of success. However, the increasing demands on the scarce healthcare resources available made it necessary to be more efficient and direct in control and prevention actions. In order to improve our efforts, we recognized the usefulness and necessity to incorporate disease surveillance into our routine patient care activities. The importance of surveillance in reducing the incidence of nosocomial infections is well documented in the literature.1-3 The Institute of Medicine, in a recent report,4 called for increasing the collection of nosocomial infection surveillance data in order to increase our knowledge of nosocomial infections. In our initial surveillance enthusiasm, we incorporated comprehensive or total surveillance throughout the hospital. However, the realities of life came dramatically (and at times traumatically) into the picture and the "bandwagon" of surveillance was appropriately challenged.5 Surveillance may be defined as the continued collection of data appropriate to defining the problem, collation and analysis of these data, and preparation and distribution of a summary report to those with an interest in and/or a need to be informed about the problem. A logical endpoint to surveillance is formulating control and prevention measures from interpretation of the analyzed data. Without a specific action, surveillance is purely archival; that is, the data increases use of shelf space, but does not decrease the occurrence of disease.6