Nosocomial infection: update.

A preceptor program on nosocomial infection is offered at the Tuskegee VA Medical Center every six months. It is the only program of this type offered by any VA hospital. Enrollees include infection-control officers from regional hospitals who attend lectures and demonstrations covering a broad range of related issues. It is now accepted that such preceptorships, by increasing awareness of the risk factors and understanding of available preventive controls, can reduce the incidence of nosocomial infections.Up to 5 percent of the 40 million patients admitted to US hospitals each year are compromised by an infection acquired during the hospital stay. This leads to 70,000 deaths per year. The urinary tract is the origin of 40 percent of all nosocomial infections, and surgical wounds account for another 25 percent. Pneumonia is the culprit in 15 percent of cases. Primary bacteremias make up only 4 percent of nosocomial infections, but the mortality is 30 to 50 percent.Staphylococci and gram-negative bacilli, especially E coli, are the common organisms found in hospital-acquired infections. Opportunistic pathogens such as Pseudomonas, Serratia, Candida, and a host of others, including Legionella, are found in debilitated patients.