Selected aspects of nosocomial infections in the 1980s.

Unusual or rare pathogens and syndromes may become significant problems in nosocomial infection. Pathogens that usually produce community-onset disease, particularly respiratory viruses, Legionella, and atypical mycobacteria, also cause nosocomial infection. Conversely, nosocomial pathogens may also produce disease in the community, as has been seen with Clostridium difficile. Contamination of parenteral and antiseptic solutions continues to be a problem in hospitals. Hospital-acquired viral infections are receiving increasing recognition. Nosocomial gastrointestinal infections, although of low frequency, are of major import because of their epidemic potential. Airborne transmission of pathogens is becoming more apparent at the same time that recognition of the importance of hand transmission creates hope for infection control. Antibiotics influence the type of microorganisms that colonize patients, but the host determines superinfection.