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General principles of infection control

N Deborah Friedman, MPH, MBBS, FRACP, MD
Daniel J Sexton, MD
Section Editor
Anthony Harris, MD, MPH
Deputy Editor
Elinor L Baron, MD, DTMH


Infection control is a discipline that applies epidemiologic and scientific principles and statistical analysis to the prevention or reduction in rates of nosocomial infections. Some experts in the field now prefer to use the phrase "infection prevention and hospital epidemiology" over the term infection control, as the words prevention and epidemiology more accurately define the discipline. Indeed, infection control is a key component of the broader discipline of hospital epidemiology. Effective infection control programs reduce rates of nosocomial infections and are cost-effective [1].

The recognition that infectious agents can be transmitted within hospitals to susceptible patients and healthcare workers began in the 1840s when Semmelweis noted that puerperal fever was associated with the lack of handwashing among clinicians performing autopsies [2,3]. This discovery, in turn, led to the introduction of hand dips with chlorinated lime at Vienna General Hospital [3]. Eventually these ideas evolved into current guidelines about handwashing, although Semmelweis promoted hand cleansing and, paradoxically, was opposed to handwashing with soap and water [3].

Infection control programs became a requirement in the United States largely as a result of the mandates of the Joint Commission for Accreditation of Hospitals (JCAHO) and the leadership guidelines and definitions of the Centers for Disease Control and Prevention (CDC).

In order to achieve the main goal of preventing or reducing the risk of hospital-acquired infections, a hospital epidemiology program should have the following oversight functions and responsibilities [4]:

Surveillance, either hospital-wide or targeted


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