Prevention and control of nosocomial infections and resistance to antibiotics in Europe - Primum non-nocere: elements of successful prevention and control of healthcare-associated infections.

In October 2004, the WHO launched the World Alliance for Patient Safety. In 2006, the Council of Europe adopted a recommendation on the management of patient safety and prevention of adverse events in healthcare to acknowledge that patients can expect each EU health system to secure a systematic approach to ensuring patient safety. This review is a compilation of broadly accepted instruments for the prevention and control of healthcare-associated infections and resistance to antibiotics in Europe. Antibiotic-resistant bacteria do not stop at the exit of a hospital. The implementation of the various elements of a whole bundle of recommended prevention and control measures in the context of interacting healthcare institutions including long-term care, rehabilitation facilities, ambulatory care practices, and home care, is therefore facilitated by the establishment of regional networks and the integration of prevention and control strategies into disease management programmes. In order to increase efficiency of prevention and control measures, there is a need for the careful design of interventional studies to figure out the most efficient single or bundle of preventive measures. In addition, methods for the discovery of clusters on the basis of routinely obtained data should be improved. Copyright 2010 Elsevier GmbH. All rights reserved.