Nosocomial infection surveillance in the United States: historical perspective.

During the past 30 years, many important strides have been made in the prevention of nosocomial infections in the United States. Infection control programs have been established in hospitals throughout the country. Techniques for surveillance of nosocomial infections have been developed and utilized extensively. Results of the Study on the Efficacy of Nosocomial Infection Control (SENIC Project) and the experience with surveillance of surgical wound infections have documented the fact that surveillance is an integral component of an effective nosocomial infection control program. In recent years, a number of approaches to nosocomial infection surveillance have been proposed as alternatives to comprehensive or hospital-wide surveillance. In 1986, four surveillance components were introduced in the National Nosocomial Infections Surveillance (NNIS) system to provide participating institutions the option to tailor their surveillance program to their local needs and priorities while continuing to provide information to the national database on nosocomial infections. Infection control practitioners currently face a challenge to develop more meaningful nosocomial infection rates to permit identification of new infection control priorities for their institution and to assess progress toward specific prevention objectives.