HOSPITAL-ACQUIRED INFECTIONS IN HEAD-NECK SURGERY .1. REVIEW

Hospital-acquired or nosocomial infections are infections that are nei ther present nor incubating at the time of admission. They must become manifest by 48 h after admission. They raise significantly the morbid ity, mortality, and economic burden of the underlying disease. Nosocom ial infections occur in 2.5-9.5% of all hospitalizations. They are mai nly found in intensive care units and surgical wards. Urinary tract in fections are the most frequent, followed by wound infections, pneumoni a, infections of the skin and mucosa, bloodstream infections and other s. The major pathogens causing nosocomial infections are Staphylococcu s aureus, Escherichia coli, enterococcus and Pseudomonas. Methicillin- resistant pathogens must be considered. In Germany the direct costs of excessive hospital stays exceed 3 billion DM annually. Preventive mea sures reduce current nosocomial infections. The CDC suggest that these measures include a trained hospital epidemiologist, an infection cont rol nurse, an active surveillance program and data feedback to surgeon s about their wound infection rates.