Important characteristics of hospital infection control are specific to pediatric facilities. For example, colonization and infection with vancomycin-resistant enterococci, which are widely spread in many units housing adult patients, are uncommon in children, especially in the neonatal intensive care unit where vancomycin use is heavy. Characteristics of the neonatal intensive care unit, such as the insulated environment and infrequent treatment with antibiotics with broad anaerobic activity, likely account for this finding. Artificial fingernails have been discovered to promote colonization with potential pathogens; their implication in recent nursery epidemics emphasizes the need to prohibit their use in this environment in particular. Finally, nosocomial viral infections occur with regularity in pediatric hospitals. Programs that successfully and cost-effectively control hospital spread of respiratory syncytial virus, however, demonstrate that rational, multifaceted interventions can nearly eliminate transmission of certain viral pathogens on the pediatric wards.