[Infectious risk in medical offices: a reality to be fought]

The notion of nosocomial infection is intimately related with that of working or sejourning in a health care institution and would thus not concern the physician's office. Nevertheless, the risk of infection does exist in this setting, both for patients and personnel, and requires adequate preventive measures. The practitioner is called upon to care for patients who have community-acquired or possibly nosocomial infections following hospitalization and must therefore know the type of germ involved, its characteristics, particularly antibiotic sensitivity, the predominant modes of transmission and preventive measures against propagation, latrogenic infections such as abscess formation at a point of injection or septic arthritis after infiltration may also occur. Other more technical procedures (endoscopy, minor surgery) may also be a cause of contamination. The practitioner also produces wastes (needles, vaccine syringes, dressings) which must be disposed of in accordance with legal regulations. One must avoid contaminating oneself in order not to contaminate others. This requires adequate knowledge and application of elementary rules concerning hand washing, asepsis, antisepsis, and waste disposal, essential links in the chain of infection transmission.