[Nosocomial infections in head and neck surgery. 1]

Hospital-acquired or nosocomial infections are infections that are neither present nor incubating at the time of admission. They must become manifest by 48 h after admission. They raise significantly the morbidity, mortality, and economic burden of the underlying disease. Nosocomial infections occur in 2.5-9.5% of all hospitalizations. They are mainly found in intensive care units and surgical wards. Urinary tract infections are the most frequent, followed by wound infections, pneumonia, infections of the skin and mucosa, bloodstream infections and others. The major pathogens causing nosocomial infections are Staphylococcus 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 measures reduce current nosocomial infections. The CDC suggest that these measures include a trained hospital epidemiologist, an infection control nurse, an active surveillance program and data feedback to surgeons about their wound infection rates.