INFECTION CONTROL Hospital Infections from the WHO Perspective

There is an increasing awareness of the importance of the suffering and financial cost caused by nosocomial infections. The World Health Organization (WHO) has not been in the forefront of activities in this field. For a long time it has held the role of a passive observer of many national activities, unlike the US Centers for Disease Control or the Council of Europe. For many years these groups have been instrumental in initiating national studies. WHO became more active only in the mid-1970s. Thousands of papers on nosocomial infections are published yearly. Most European countries have hospital infection surveillance committees and many have laws, guidelines, and surveillance systems, some on a computerized nationwide scale. Excellent practical systems and methods have been developed or tested in disinfection, cleaning, isolation, and care procedures. Meaningful prevalence data have accumulated, control measures have been devised and, above all, the cost has been reduced. However, the fact remains that these efforts have met with varying degrees of success or even failure. It has become increasingly obvious that the microorganisms in the inanimate hospital environment contribute negligibly to endemic nosocomial infections. 3 The American Hospital Association stated that routine environmental sampling of the hospital air, floors, and objects has not contributed significantly to the prevention of nosocomial infections. Responsible organisms appear to be derived more often from the human body (including hospital employees and visitors) ra ther than the inanimate environment. Nosocomial infections are considered a worldwide problem, affecting both the developed and developing countries. These infections occur in both epidemic and endemic forms and are among the major causes of morbidity and mortality in hospitalized patients, leading directly or indirectly to the emergence of new health