[Microbiological control of hospital infections]

In the recent years there is a growing interest in Nosocomial Infections in Italy, because of current studies providing useful information on hospital epidemiology, hospital cost and infection control measures. Besides there is an increasing awareness that clinical and epidemiologic data provide a more important support for infection control program than microbiologic data, which are not always required to identify Nosocomial Infections. Still a reliable microbiology laboratory is an integral support system for infection control program, contributing information on Nosocomial Infection Surveillance and Education of personnel. Over the past five years in the Hospital of Frosinone, prevalence and incidence studies on patient population and microbiologic monitoring were performed. All investigations were accomplished by the Hospital Infection Control Team by collecting and reporting data on special forms, since 1988 information on microbial cultures were included. The prevalence and incidence studies have demonstrated few microbial isolates compared to the number of infections identified. Antibiotic monitoring is considered an integral component of Infection Control Programs, contributing to the surveillance of emerging resistance. All data concerning microbial isolates have been routinely an orderly collected and tabulated. A three-monthly report is distributed throughout the hospital and pertinent data are briefly reviewed. This simple method of surveillance is used to identify trends in problem areas, support antibiotic policy statements and serve as a focus for educational programs of personnel. These routine studies have some limitation: 1) all microbial agents are considered, irrespective of nosocomial infection cases; 2) 100-120 hours of work from an infection control nurse are required. Therefore microbial data are not adequate in containing Nosocomial infections, if not supported by Infection Control Team's investigation.