Disinfection and the control of nosocomial infection.

Nosocomial or hospital acquired infections have become a major cause of morbidity and mortality today. The reported rates of nosocomial infection vary depending on the efficiency of the surveillance system and the definitions of infection employed. In the United States it has been estimated that about 5% of hospitalised patients acquire a nosocomial infection. This works out to be nearly 2 million infections per year!. In Malaysia the true rate of nosocomial infection is unknown. A recent Ministry of Health survey gave an overall incidence of 1.3% but this is likely to be an underestimation2• Incidence rates are often difficult to establish since it requires the close and continuous cooperation of ward clinicians and nurses. Nosocomial infections may also only manifest after the patient is discharged and such nosocomial infections are often not recorded. The cost of nosocomial infection is correspondingly high. The average cost of a nosocomial infection in the United States is more than a thousand dollars thus the total annual expenditure related to the management of nosocomial infection could exceed 2 billion dollars3• In the United Kingdom nosocomial infection was estimated to have cost 115 million pounds in 19874.