Sheer frequency of concern makes most surgeons consider themselves reasonably well-informed, practical microbiologists. Ever since Kocher bellowed "Fort mit dem spray" and flooded the operative field with an aerosol of phenol, surgeons have stayed reasonably up to date with the causes and prevention of infection. It has been a struggle to remain current with each new antibiotic as these agents proliferate into the third and fourth generations, but a determined band of very well-informed drug-house representatives with great skill, tact, and inducements (ie, coffee, donuts, and notebooks) have served as admirable teachers.
During the past ten years, however, there has been an uneasy feeling among surgeons that we are falling behind in remaining current regarding the immunology of host defense against infection. This concern has become more pertinent as an increasing number of patients kept alive by adjunctive means following severe trauma, burns, or major operations are, in their immunosuppressed