Surveillance methods vary in different hospitals, but are mainly based on laboratory reports, as in Sweden. These reports are supplemented by ward visits by the infection control nurse and by the usual epidemiologic methods in the investigation of outbreaks.

An increasing interest in surveillance of hospital infection occurred in the 1950s when outbreaks of staphylococcal infection were causing problems throughout the world. The appointment of an MD as infection control officer in every hospital was suggested in 1955 by Colebrook in the Birmingham Accident Hospital, but no full-time officer has so far been appointed in the United Kingdom (UK). The task was taken on by medical microbiologists, who are usually physicians and, currently in England and Wales, make up 82% of infection control officers.”

In the early days, the recording of the incidence of infection was usually confined to surgical wounds, as in the US. The problem of collecting a large amount of data by the microbiologist was recognized by Moore who appointed the first infection control nurse.” He also described the importance of laboratory reports in the early detection of outbreaks.

Surveillance was a major topic for discussion at the international Conference on Nosocomial Infections in 1970, and Moore suggested that incidence rates were of little value for determining changes in a hospital or for comparisons between hospitals. The number of infections in individual hospitals was too small for statistical comparison, particularly if rates were low and infections influenced bv many factors were not corrected for in the overall rates.