New problems in hospital infection have arisen since the publication of the first edition. Methicillin-resistant Staphylococcus aureus have been causing increasing infections all over the world. The prevention of the spread of these organisms has increased the need for effective isolation procedures and the provision of suitable isolation facilities in individual hospitals. Outbreaks of Legionnaire’s Disease have occurred, and have often been due to inadequate maintenance of cooling towers and water supply systems. However, the predominent anxiety has been the emergence of the human immunodeficiency virus (HIV). Although there have been few reports of transmission to health care staff, the risk, however remote, of developing AIDS has led to a reconsideration of methods of avoiding blood-borne infection. The precautions introduced have often been unnecessarily extreme, and not based on the actual risk, which is low in most hospitals. The potential risk has involved new studies on methods of decontamination of equipment and surfaces. For similar reasons, the overall hazards of infection to hospital staff have received increasing attention, as have the risks of food poisoning to staff and patients, particularly in relation to cook-chill systems. Nevertheless, these recent problems still represent a small part of the overall problem of hospital infection; of the 10% of infections acquired by patients, most are still of surgical wounds, urinary or the respiratory tract. The cost of infection has to be considered carefully by infection control detention of high risk patients and concentrating resources on these rather than spreading the rather limited resources equally over the whole hospital. The basic principles of infection control have changed very little and all hospital staff need to be taught these principles, and a major task of infection control doctors and nurses is to produce, implement and monitor effective policies. It is hoped that this new edition will continue to provide staff with an understanding of hospital acquired infection. Although the book is primarily an introduction for infection control nurses and microbiologists, much of the information should be useful to other grades of staff as indicated in the preface to the first edition.
