Studies estimate that one in twenty patients acquire infections during a hospital stay.

Rates of resistance to the antibiotic methycillin rose from just 2 percent of common Staphylococcus bacteria in 1972 to 63 percent in 2004, according to the Centers for Disease Control and Prevention, which issued the guidelines.

The guidelines urge hospitals and other facilities to prioritize control efforts and to do more to monitor infection rates among patients.

"What we're asking today is simple but not easily achieved," said CDC official John Jernigan.

Overprescribing of antibiotics is blamed as the major cause of drug resistant infections. Antibiotics are often given preventatively or when doctors suspect an infection. But the drugs are useless against viral illnesses like flu, and overuse breeds stronger and stronger generations of potentially dangerous bacteria.

The guidelines call on hospitals to educate doctors and nurses on conservative use of antibiotics. Other efforts are surprisingly basic. Doctors, nurses, orderlies should also be trained to wash their hands every time they enter a patients' room, to minimize the risk of transmitting pathogens from others, the recommendations urge.

But the guidelines acknowledge that modifying health practices and policies in thousands of U.S. health care facilities requires a cultural shift.

Will Sawyer, a family physician from Cincinnati, Ohio, said overworked hospitals and nursing homes have a hard time observing basic hand-washing protocols requiring them to scrub up every time they enter a patient's room.

He urges programs to make health workers acutely aware of everyday behavior that can turn them into carriers and transmitters of drug-resistant bacteria.

"Am I an eye-rubber, nose-picker, or thumb licker?" Sawyer asked.

Groups setting hospital quality standards have begun to including basic infection control practices in their measurements. Some hospitals already report their results under Medicare program tying the reporting to increased payment rates.

But not all hospitals agree to institute standard practices or report on their rates of in-hospital infections.

Charles Denham, who is CEO of HCC Corp., a hospital consulting firm, said Medicare would move as early as 2008 to tie its payments to hospitals' success in controlling the spread of drug-resistant bacteria and other pathogens. "I think the handwriting is on the wall," he said.

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