[Strategy against nosocomial infections in France].

Because of their extent and due to the complexity of their management, nosocomial infections (NI) have become a public health problem in view of ethical and economical considerations. A decree, issued on 05.06.1988, organizes the supervision and the prevention of NI throughout the country and requires the setting up of a committee against nosocomial infections (CLIN) in every medical establishment. In 1992 five inter-areas coordination committees (C-CLIN) and one national technical struggle committee (CTIN) were established in France. A governmental plan was instituted in 1994. This plan, enacted in the 04.19.1995 text, focuses on the importance of reducing by 30% the frequency of NI by the year 2000. The creation of a NI cell in the Health Ministry and of operational hygiene teams in the hospitals have since then strenghtened the anti-infection system. The CLIN became a compulsory institution in the 1998 for private establishments and a new decree is to be issued at the end of 1999 and to come into force on 12.31.2001 at the latest. Finally, the decree n degrees 98-535 (07.01.1998) sets up the French Agencies for Health Safety and an Institute of Sanitary Supervision. Both structures are in charge of the surveillance system in Health establishments. The CTIN and the C-CLIN, together with groups of experts and learned societies (Superior Council for Public Hygiene in France, French Society for Hospital Hygiene, Health National Agency of Accreditation and Valuation), will edit official guide of technical recommendations. This ambitions strategy, based on education, information, supervision and prevention methods, requires a multidisciplinary mobilization and needs the compulsory support of the extire hospital community.