Nosocomial infections in immunocompromised children.

Within the last decade several advances in medicine have resulted in extended longevity of children with cancer, cystic fibrosis, certain congenital immunodeficiency disorders, chronic renal diseases and aplastic anemia. Forthwith, the population of such immunocompromised children has increased and accounts for a greater portion of the hospital census than heretofore. To avoid emotional, infectious and financial burdens of hospitalization, efforts have been successful in developing ambulatory outpatient programs within specialized centers. Although infection control policies have been reasonably well-established for the hospitalized inpatient, policies for the hospital outpatient are lacking. Investigations into the problems of "nosocomial outpatient infections" are needed. Accomplishments in recent years in the control of nosocomial infections include the development of preparations for passive immunization for varicella-zoster virus and hepatitis B virus exposures and the application of certain antibiotic regimens for prophylaxis. Currently a vaccine is under study for active immunization to varicella with possible efficacy for exposed susceptible persons. It is obvious that the proportion of children at increased risk for infection in the hospital environment will continue to increase.