Nosocomial infections--a 1980 view: progress, priorities and prognosis.

Following a brief historic perspective, this review highlights the progress that has been made in the field of nosocomial infections in the past decade. Scientific progress has been made in a few efficacy studies, the determinative role of the host, concepts of immunoincompetence, emerging pathogens, such as Legionnella pneumophila, the epidemiology of antimicrobial drug resistance and concepts of chemoprophylaxis. Major advances have been made in preventing a few specific nosocomial infections such as hepatitis B. The evolving roles of infection control practitioners and hospital epidemiologists represent important progress in meeting manpower needs. Major failures of the past decade include the continuing absence of an acceptable scientific basis for infection control, the lack of standards for hospital infection control and the consequent inability to carry out effective education. Major challenges in the 1980s will be to determine what is effective and what is not in infection control activities, and to focus control activities and recommendations more sharply.