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Introduction: in dentistry, many treatments are invasive and can lead to infections. The purpose of this study was to evaluate the prevention of healthcare-associated infections in the dental practice in Rabat. Methods: a survey on the prevention of healthcare-associated infections in Rabat dental practices was conducted among 324 practitioners. A self-administered questionnaire was used to assess their training, hygiene, protection, organization of premises, asepsis, antisepsis and use of medical devices. Data were collected using JAMOVI version 1.8.4, the Χ² and Fisher tests were used to compare the variables, the significance level was set at P<0.05. Results: only 80 subjects took part in the study. All the dentists had protective equipment, but 68 (85%) did not have instructions on what to do in case of accidental exposure to blood; 41 (62.1%) operators had qualified assistants, 36.4% had a team vaccinated against hepatitis B and 61.3% of operators and assistants had been trained to handle reusable medical devices. Seventy-six studies had isolated examination rooms, 41 had a steam steriliser and a sorting area with sharps collector. However, 35.1% had a contract for the collection of waste generated by health-care activities, posing a significant risk of infection. Conclusion: the results of this study show that most practitioners in Rabat comply with the majority of the aseptic and hygienic standards in dentistry. However, more needs to be done to ensure that staff are vaccinated. [ABSTRACT FROM AUTHOR]

The possibility of hepatitis C being transmitted between dental patients was the genesis of an extensive and expensive look-back investigation conducted by an Ontario Public Health Unit. This investigation was performed with a minimal knowledge of nosocomial infections of dental origin, an enthusiastic reliance on untested checklist indicators and an absence of any of the criteria justifying such an investigation. As a consequence, the entire exercise was based on the false premise that an infection control lapse had occurred. This commentary will address these flaws, and other aspects of the Public Health Unit’s response that detracted from its credibility. The provision of a realistic assessment of disease transmission in dentistry should result in Public Health Units conducting informed and mutually beneficial inspections of dental practices.

Résumé: L'hypothèse selon laquelle des bactéries multirésistantes (BMR) « invisibles » pourraient se cacher dans les flores polymorphes est vraie même si leur nombre paraît peu important dans cette étude. Les flores polymorphes en revanche peuvent être en grand nombre puisqu'elles sont observées dans 24 % dans cette étude (et même dans 30 % dans une étude précédente réalisée dans les mêmes unités hospitalières). Un ECBU chez la personne âgée est non seulement un acte invasif, voire agressif, mais encore onéreux. L'objectif de l'étude était de répondre à la question suivante : faut-il faire un ECBU systématique à tous les sujets âgés hospitalisés en unités de médecine aiguë et soins de suite gériatriques ? Les résultats de cette enquête suggère que la réponse est non, d'autant plus que c'est bien la logique de la pertinence de l'ECBU qui prévaut chez les patients sondés, atteints de iatropathologie et de pathologies chroniques à l'origine de réduction des défenses immunitaires tels que le diabète, la corticothérapie au long cours, les thérapeutiques immunosuppressives, les maladies urologiques, la grabatisation chronique compliquée, etc. [ABSTRACT FROM AUTHOR]

Nosocomial infections are a real global public health problem. Pulmonary tuberculosis and HIV co-infection increases the incidence of nosocomial infections because of immunosuppression and iterative hospitalizations. We here report four cases of patients aged 28, 36, 42 and 52 years coinfected with HIV and tuberculosis (multifocal tuberculosis in 2 patients, miliary tuberculosis, bacteriologically confirmed tuberculosis), all with CD4 < 100 cells/mm³. During the intensive-phase, patients received antitubercular drugs and antiretroviral therapy (ART). They had been admitted to the Department of Infectious Diseases at the G-Point University Hospital with productive cough and/or hyperthermia following hospital stay greater than 48 hours. Patients' history revealed that one patient had not been compliant with tuberculosis treatment because of adverse reactions classified as minor. There had been no clinical improvement in the three remaining patients despite their optimal compliance to different treatments. Cytobacteriological examination of sputum and/or testing of the feeding tubes, blood cultures and specific samples allowed to identify multidrug-resistant Klebsiella pneumoniae. The clinical course of these patients was favorable under specific antibiotic therapy. Nosocomial infections may be misinterpreted and associated with poor therapeutic response in patients receiving TB treatment. Cytobacteriological examination of the biological fluids should be systematic in patients co-infected with HIV and tuberculosis and hospitalized for at least 48 hours, in whom pulmonary signs and/or fever persist despite their good compliance to treatment. [ABSTRACT FROM AUTHOR]

Introduction: the sterilization of surgical drapes plays an important role in preventing infections associated with treatments. At the CNHU-HKM, sterilization procedure for drapes encounters problems. The purpose of this study was to examine the factors associated with the quality of sterilization of surgical drapes at the CNHU-HKM. Methods: we conducted a cross-sectional, descriptive and analytical study focusing on 20 sterile surgical drapes, 41 agents were involved in the management of drapes and 55 members of the surgical team. The probabilistic method was used for sterile surgical drapes, the non-probabilistic method for the others. Pearson's Chi-square Test and logistic regression were used to find the association, with a significant threshold and a p<0.05. Results: eighty six point forty six percent of subjects were males with an average age of 42 years. The quality of the process of sterilization of the operative drapes was not good in the two departments responsible for processing the drapes. Bacteriological analysis showed that, out of 20 sterile surgical drapes, 9 had Acinetobacter spp. a multidrug-resistant germ causing nosocomial infections. Multivariate analysis showed that professional experience (p=0.015) and quality control of the procedure (p=0.034) were statistically associated with the quality of sterilization. Conclusion: the presence of Acinetobacter spp. on the sterilized drapes demonstrates that sterilization of drapes at the CNHU-HKM is of poor quality. Measures strengthening the skills of providers are necessary to improve the quality of sterilization procedures. [ABSTRACT FROM AUTHOR]

Introduction: blood cultures are the best diagnostic tool for the detection of bacteremia. However, false positive results may lead to confusion about antibiotic regimens, putting the lives of patients at risk. The main purpose of this study was to assess the prevalence of coagulase negative Staphylococci (CoNS) as well as of Corynebacterium spp and Bacillus spp in the bags of blood culture analyzed in the microbiology laboratory at the Ibn-Rochd University Hospital in Casablanca. This prevalence was evaluated according to various Hospital Departments over the year 2016. Methods: we conducted a descriptive, retrospective study by analysing the computerized database of the Laboratory of bacteriology and virology at the Ibn-Rochd University Hospital in Casablanca over a 12-month period from 1 st January to 31 st December 2016. Our study focused on bacteria forming part of the commensal flora (coagulase negative Staphylococcus, Corynebacteria spp and Bacillus spp). The blood culture bags were incubated in the automated blood culture system (Bactec FX). The identification of the germs from a positive culture was performed according to the standard techniques of bacteriology and susceptibility testing was performed according to EUCAST 2015. We conducted an analysis of the computerized database of KALISIL system (Netika) version (2.2.10.) of the Microbiology Laboratory at the Ibn-Rochd University Hospital in Casablanca. Results: out of 7959 requests for blood cultures obtained from 5801 patients addressed to the laboratory of bacteriology, 2491 were positive, of which 848, reflecting a rate of 34% of positive bags or 10.6% of the whole of bags received over the year 2016, were positive for coagulase negative Staphylococcus, 56 bags of blood cultures, reflecting a rate of 2.2%, were positive for Corrynébacteruim SP, followed by 60 bags of blood cultures, reflecting a rate of 2.4%, which were positive for Bacillus sp. The frequency of isolation of coagulase negative Staphylococcus compared to other bacteria according to Clinical Departments showed a higher frequency in the Paediatric Department (47.2%) followed by the Medicine Department (44.1%). Conclusion: this study shows that coagulase negative Staphylococci are the organisms most frequently isolated from blood cultures. They are a non-negligible cause of nosocomial infections, but they are also the most common blood culture contaminants. [ABSTRACT FROM AUTHOR]

Pseudomonas aeruginosa est l'une des bactéries opportunistes les plus pathogènes pour l'homme. Il est responsable d'un nombre élevé d'infections nosocomiales en réanimation. Plusieurs études ont rapporté un taux élevé de morbimortalité due à ce germe. Cependant, le point sur les facteurs de résistance aux antibiotiques ainsi que les facteurs de mortalité liés à ce germe restent un sujet d'actualité. Durant ces quatre dernières années l'incidence des infections nosocomiales à P. aeruginosa est en nette augmentation dans notre hôpital, ce qui nous a poussés à faire cette étude épidémiologique visant à trouver l'incidence vraie de ces infections dans notre service ainsi qu'à identifier les facteurs de résistance du P. aeruginosa aux antibiotiques et les facteurs de risque de mortalité liés à ce germe. [ABSTRACT FROM AUTHOR]

Nosocomial infections are a major public health problem. They are mainly caused by bacteria that often present antibiotic resistance profiles, which complicates their management. The diagnosis of these infections is based on clinical and biological criteria that lack sensitivity and specificity, and on microbiological examinations that are lengthy. Unfortunately, the inadequate empirical antibiotic therapy in many cases, and the late implementation of an effective treatment, are associated with the emergence and spread of bacteria that are multi-resistant to antibiotics, i.e. strains producing extended-spectrum beta-lactamases (ESBL). Rapid diagnostic methods, identifying the pathogen and its resistance profile, are therefore necessary. Our laboratory is committed to develop PCR techniques to genotypically identify the most frequent ESBLs from four hospital facilities. Among all the enterobacteria detected, we observed the predominance of OXA type ESBL (38%), followed by CTX-M type ESBL (33%). TEM and SHV genes represent respectively 19% and 10%.The optimization of these technologies could allow the identification of all known resistance mechanisms in only a few hours and find new preventive or curative strategies in the fight against these nosocomial infections, to better respond to this health threat.

Introduction: The fight against nosocomial infections, particularly those linked to environmental germs, is one of the priorities of health establishments. Microbiological control of the hospital environment is an essential element of the strategy for the fight against these infections. The aim of this study is to determine the microbial ecology of hospital surfaces and medical devices. Methods: This is a study, which was carried out in the El Idrissi hospital in Kénitra. For the microbiological control of surfaces, we opted for the swab technique: the search for specific germs on flat surfaces and in areas that are difficult to access and not flat. Results: Among the bacteria most frequently responsible for isolated nosocomial infections: Bacillus (28%) and coagulase-negative staphylococci (27%) were predominant, followed by Staphylococcus aureus (19%), Klebsiella pneumoniae (17%), Pseudomonas aeruginosa (5%), Enterobacter cloacae (3%) and Proteus vulgaris (1%).The overall distribution of germs by department showed their predominance in intensive care units (30%), traumatology (11%), emergencies (11%) and in operating rooms (9%). Conclusion: Periodic microbiological controls must be put in place in order to identify any contamination, to carry out preventive actions, procedures and a fundamental approach for the control of infectious risks in the hospital.

Although the number of ICU beds is generally limited, the incidence rates of nosocomial infections is high. Managing infectious risk in ICU is a priority today; one of the strategic aims is the establishment of systems for epidemiological control. The aim of our study is to determine the incidence and the clinical aspects in order to identify the risk factors. We conducted a longitudinal descriptive impact assessment study enrolling patients hospedalized for more than 48 hours in general purpose Intensive Care Unit at the Ibn El JAZZAR Hospital, Kairouan over a period of 1 year, from 01/03/2013 to 28/02/2014. The study focused on 265 patients whose average age was 39±20 years (18-93 years) with a sex ratio(M/F) of 2.48. We identified 125 episodes of nosocomial infections in 81 patients corresponding to a total incidence of 30.6%. The incidence density rate was 55 infections per 1000 days of hospitalization. There was a clear predominance of pneumopathies, with an incidence of 27.73%, followed by urinary tract infections (9,73%), infections associated with central venous catheter (6.25%) and surgical site infections (2.34%). Mortality rate of patients was 28.7%, with a significant difference between infected patients (44.7% of cases) and non-infected patients (29.07%) (p < 10-3). Gram-negative bacteria were found in 80% of cases. Prevention must involve a global and multidisciplinary action. [ABSTRACT FROM AUTHOR]

INTRODUCTION: hospital-acquired infections (HAIs) constitute a serious global public health challenge, causing great suffering to many people across the globe at any given time. This study ascertains the knowledge of health professionals on the challenge and their compliance with infection control measures. METHODS: validated questionnaires were administered to 660 health professionals and supported with face-to-face interview. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 16.0 (SPSS Inc, USA). Chi-square was used to test association between the independent and the outcome variables. Cut-off point for statistical significance was 5% (p value=0.05). RESULTS: UTIs (61.4%) followed by hospital-acquired pneumonia (55.6%) were known to be the most prevalent HAIs in government hospitals while staphylococcus aureus (54.4%) was reported the most microbial agent. In private health facilities, Hospital-acquired Pneumonia was known to be the most common (66.1%) while pseudomonas aeruginosa was the most reported culprit. HAIs were reported to have occurred more in government hospitals and catheterization was the commonest modes of transmission in both health facilities. CONCLUSION: the prevalence of HAIs in this state was reported to be high. Although health-care professionals have good knowledge of HAIs, active effort is not always made to identify and resolve them. Standardized surveillance of HAIs is urgently needed.

Copyright of Reanimation is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BioVersys, founded in 2008, is working on bringing a technology for screening and for the development of 'transcriptional regulator inhibiting compounds' (TRICs) to patients in order to overcome antibiotic resistance. The co-founders share their view on what makes successful scientists pursue a career as start-up entrepreneurs rather than a classic academic career. They describe the history and milestones of their company, and how their everyday work differs from that of peers in an academic or industrial research setting.

Résumé Contexte et objectifs La dénutrition favorise le développement de pathologies nosocomiales comme les escarres (ESC) et les infections nosocomiales (IN), mais les paramètres nutritionnels les plus fortement prédictifs de ces pathologies sont encore à préciser. Matériels et méthodes Dénutrition, IN et ESC ont été recensées conjointement au sein de 13 établissements de soins de la région Champagne-Ardenne. L’évaluation nutritionnelle a porté sur le pourcentage de perte de poids, l’indice de masse corporelle (IMC), l’albuminémie, le Nutritional Risk Index (NRI) et le Geriatric Nutrition Risk Index (GNRI). Les données ont été analysées en fonction du niveau de gravité clinique, et des statuts immunitaire et inflammatoire. Résultats Au total, 2323 patients adultes ont été inclus, avec un âge moyen de 68,9 ans. La prévalence des IN était de 4,3 % et celle des ESC de 6,1 %. L’IMC a été obtenu chez 96 %, le NRI chez 72 % de l’ensemble des patients ; et le GNRI chez 65 % des sujets âgés. Le taux d’albuminémie < 30 g/L et le score du NRI < 83,5 étaient les plus prédictifs d’IN (risques relatifs respectifs de 4,39 et 4,42) et d’ESC (3,22 et 3,61), même en présence d’une inflammation. Chez le sujet âgé, l’utilisation du score du GNRI sous-estimait le risque nutritionnel. La dénutrition restait un facteur prédictif d’IN chez les patients immunodéprimés, indépendamment du score de Mac Cabe. Conclusion Ces données suggèrent que le taux d’albuminémie et le score du NRI sont, indépendamment de l’âge et de l’inflammation, les meilleurs facteurs prédictifs du risque nosocomial en rapport avec la dénutrition. Background and aims Malnutrition promotes the development of nosocomial pathologies such as pressure ulcers (PU) and nosocomial infections (NI), but the best nutritional predictive factors of these pathologies need to be more precisely determined. Materials and methods Malnutrition, inflammation, NI and PU were jointly checked by experienced investigators in 13 health care facilities from the Champagne-Ardenne region in France. Nutritional assessment focused on weight loss percentage, Body Mass Index (BMI), serum albumin level, Nutritional Risk Index (NRI), and Geriatric Nutrition Risk Index (GNRI). Data were analyzed by taking into account clinical severity level, and inflammatory and immune status. Results A total of 2323 patients (> 18 years) were included, with a mean age of 68.9 years. Prevalence of NI and PU were respectively 4.3% and 6.1%. BMI was available in 96% of cases, NRI in 72% of the whole population; and GNRI in 65% of the 1319 elderly subjects. A serum albumin value < 30 g/L and a NRI score value < 83.5 were the best nutritional predictive factors of NI (relative risks of 4.39 and 4.42) and PU (relative risks: 3.22 and 3.61), even in the presence of inflammation. In the geriatric population, GNRI score seemed to underestimate nutritional risk as compared to NRI score, thus confirming the results from a previous study. Malnutrition remained a predictive factor of NI in immune-depressed patients, independently of Mac Cabe's score. Conclusion These data suggest that serum albumin and NRI score values are, independently of age and inflammation, the best predictive factors of nosocomial risk related to malnutrition. [ABSTRACT FROM AUTHOR]

In order to develop new approaches for effectively combating antimicrobial resistance, universities of applied sciences, teaching hospitals and biotechnet industrial partners are working together in a National Research Consortium supported by the Commission for Technology and Innovation, CTI.

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Résumé Introduction L’objectif de cette étude est d’explorer dans notre unité de néonatologie les facteurs de risques de l’infection nosocomiale générée par Staphylococcus aureus , de déterminer la prévalence et la densité d’incidence de ces microorganismes, et de vérifier si ces souches sont également responsables de la formation de biofilm sur cathéters. Patients et méthodes Deux cent cinquante-trois nouveau-nés ont été inclus dans cette étude, l’aptitude à former des biofilms a été détectée par la technique de plaque de culture de tissu, et la visualisation de ces biofilms a été faite par microscopie électronique à balayage. Les concentrations minimales inhibitrices (CMI) d’antibiotiques sur des cellules planctoniques ont été déterminées par la technique de dilutions sur microplaque à 96 puits. En parallèle, la sensibilité des cellules en mode sessile a été testée vis-à-vis de sept molécules d’antibiotiques. Résultats La densité d’incidence de l’infection nosocomiale causée par S. aureus a été de l’ordre de 9,87 pour 1000 journées d’hospitalisation. Ces souches sont capables de former des biofilms et de résister à des concentrations 100 fois plus importantes que celles utilisées en schéma thérapeutique. Conclusion Cette étude a permis également d’identifier certains facteurs de risque de l’infection nosocomiale dans notre unité de néonatologie, à savoir la prématurité, le faible poids de naissance et la durée de séjour d’hospitalisation. Les souches responsables d’infections nosocomiales dans l’unité de néonatologie de L’EHS de Tlemcen peuvent également former des biofilms avec tout ce que cela implique comme risque en matière de résistance. Par conséquent elles peuvent constituer une véritable contrainte thérapeutique. Summary Introduction The objective of this study is to explore in our neonatal unit, risk factors of nosocomial infection generated by Staphylococcus aureus , to determine the prevalence and incidence density of these microorganisms and whether these strains are also responsible for biofilm formation on catheters. Patients and methods Two hundred and fifty-three newborn babies were included in this study, the ability to form biofilms was detected by tissue culture plate method, and visualization of biofilms was made by Scanning Electron Microscopy “SEM”. MICs of antibiotics on planktonic cells were determined by the dilution technique in 96-well microplate. In parallel, the sensitivity of cells in sessile mode has been tested towards seven antibiotic molecules. Results The incidence density of nosocomial infection caused by S. aureus was the order of 9.87 per 1000 patient days. These strains are capable of forming biofilms and resist 100 times greater than those used in regimens concentrations. Conclusion This study has also identified certain risk factors of nosocomial infection in our neonatal unit, like prematurity, low birth weight and length of hospital stay. Strains responsible for nosocomial infections in the neonatal unit of EHS Tlemcen can also form biofilms with everything that implies risk for resistance, therefore they can be a real therapeutic stress. [ABSTRACT FROM AUTHOR]

Résumé: Objectifs: Les pneumopathies acquises sous ventilation mécanique (PAVM) représentent les infections nosocomiales les plus fréquentes en réanimation et s’accompagnent d’une surmortalité. Le but de notre étude était d’évaluer le suivi des recommandations pour la prévention des PAVM en réanimation. Type d’étude: Étude rétrospective, observationnelle, multicentrique (26 centres). Patients et méthode: Tous les patients ventilés plus de 48heures dans les services de réanimation participant au réseau CCLIN-Ouest ont été inclus sur une durée de 1 an. Les caractéristiques démographiques des patients, la nature des protocoles de prévention de PAVM des services (absence, incomplet, complet, ou renforcé par un protocole de sédation et de sevrage ventilatoire), les densités d’incidence (DI) des PAVM et le devenir des patients ont été décrits. Résultats: Sur les 26 services de réanimation ayant participé à l’étude, 5742 patients ont été inclus. Dix services (38 % ; 2595 patients) n’avaient pas de protocole de prévention de PAVM, huit services (31 % ; 1821 patients) avaient un protocole incomplet, cinq services (19 % ; 561 patients) présentaient un protocole complet et trois services (12 % ; 765 patients) avaient un protocole renforcé. La DI des PAVM était de 14,8‰ (Interquartile [IQ] : 10,2–20,1) pour le groupe sans protocole, 15,6‰ [IQ : 12,6–16,2] pour le groupe avec protocole incomplet, 11,0‰ [IQ : 9,1–14,0] pour le groupe avec protocole complet et 12,9‰ [IQ : 7,5–12,9] pour le groupe avec protocole renforcé (p =0,742). Conclusions: Les recommandations de prévention des PAVM sont peu suivies. Des propositions d’amélioration des pratiques sont discutées. [ABSTRACT FROM AUTHOR]

Nosocomial infections constitute a significant public health problem but are poorly controlled in our health structures, especially those associated with resuscitation care. The first objective of this study was to identify the different microbial strains present in different biological samples taken from patients staying in the resuscitation unit of the Annaba University Hospital Center. The second objective was to assess the antimicrobial sensitivity of isolated microbes from the patients’ samples, to determine the risk factors, the most incriminated microbial agents in nosocomial infections. During the study period from January 2013 to December 2016, we collected 1,151 biological samples from 1,938 patients admitted to Resuscitation Medical Service. The samples were subjected to different microbiological analyses. Our results showed that over 59% of the collected samples were microbiologically positive. The identified species include Candida albicans (115 cases) and Candida.sp (81 cases). The Gram-negative bacterial strains found in the samples included Acinetobacter baumannii (108 cases), Klebssiella pneumoniae (99 cases) Pseudomonas aeruginosa (79 cases), and Escherichia coli (73 cases). Gram positive bacteria included Staphylococcus aureus (94 cases) and Enterococcus faecalis (53 cases). The antibiogram analyses showed significant antibiotic resistance reaching 93.75% for ampicillin, but sensitivity to colistin reaching 81.81%. Moreover, the fungal strains are represented by the genus albicans, showing a significant resistance to antifungals, reaching 80% with miconazole. Conclusion. The nosocomial infections in the medical unit were caused by the candida genus and multi-resistant bacteria to various antibiotics and antifungals. The most important factor associated with these infections was the use of medical devices.

Abstract: Purpose of the study: The global epidemiology of extended spectrum betalactamases (ESBL) producing Enterobacteriaceae has evolved in recent years with the emergence of a new type of ESBL: CTX-M, mainly in Escherichia coli. These CTX-M type producing Enterobacteriaceae are responsible for both nosocomial and, more recently, community infections, including urinary tract infections. The aim of our work is to study ESBL producing Enterobacteriaceae evolution between 1999 and 2007 in the population from the Centre Hospitalier du Pays-d’Aix (CHPA), a general hospital from South of France. Patients and methods: ESBL producing strains of Enterobacteriaceae isolated in odd years between 1999 and 2007 from clinical isolates of all origins have been phenotypically identified and their ESBL genotyped. Molecular and epidemiological data from our hospital health-care associated infection committee were analyzed. Results: Two hundred and sixty-two ESBL producing isolates were studied. Within ESBL producing Enterobacteriaceae, Enterobacter aerogenes was predominant in 1999 (48.7% of isolates), and decreased to 18.8% of isolates in 2007. On the other hand, E. coli, which represented 10.5% of ESBL isolates in 1999, grew up to 37.5% of the isolates in 2007. ESBL prevalence in E. coli increased during this period from 0.3 to 2.5%. Simultaneously, ESBL, predominantly TEM-24 in 1999, were replaced by CTX-M in 2007, among which CTX-M-15 is predominant (88% of CTX-M). Conclusion: Our study confirms a major change in ESBL epidemiology in CHPA, with the emergence of CTX-M type ESBL, mainly CTX-M 15, and an increase of ESBL prevalence in E. coli. [Copyright &y& Elsevier]

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Summary: In our neonatal intensive care unit, the incidence density of infections related to central catheters, assessed retrospectively over 2 years, exceeded that described in the literature. To reduce this incidence density, clinical practice guidelines were implemented for the insertion and maintenance of central lines. The purpose of this study was to evaluate the impact of the protocol on the incidence density and the incidence rate of nosocomial bloodborne infections. This was a prospective study in a neonatal intensive care unit of the Fort-de-France University Hospital over 17 months, which included all premature infants with a central line. We studied the adherence to the protocol, possible complications related to the protocol, the characteristics of the population, the incidence rate, and the density of specific central catheter-related infections. There were 111 children, 122 catheters, and 2575 catheter days during period 1 and 101 children, 125 catheters, and 1631 catheter days during period 2. Gestational age and birth weight were significantly lower in period 2 (29.6±2.3 GW vs 27.3±1.9, P =0.001; 1239±379g vs 915±175g, P <0.001) and the catheterization duration differed between the 2 periods (20±11 days vs 13±6 days, P <0.0001). A trend for a lower incidence density of infection was observed in the second period (16 per 1000 catheter days vs 10 per 1000 catheter days, P =0.06). Although the 2 groups’ baseline characteristics were different, this study suggests a positive impact of clinical practice guidelines for the insertion and maintenance of central venous catheters on the incidence of nosocomial infections related to central catheters. [Copyright &y& Elsevier]

Abstract: Ten years after its creation as part of the law on patients rights, the legislator entrusted to the ONIAM, after the compensation for no fault medical accidents and serious nosocomial infections, repair of various other medical risks in accordance with some legal and regulatory different conditions. If individual medical accidents have now a response in French law, the question of the management of medical accidents serial is still current. [Copyright &y& Elsevier]

Summary: Although enteroviruses generally cause asymptomatic or mild disease, neonates are at higher risk for severe illnesses, among which systemic disease characterized by multiorgan involvement is a potentially fatal condition. Enterovirus neonatal infections may be the source of nosocomial infections in neonatology or in pediatric intensive care units. We report central nervous system infections due to Echovirus 11 in two neonates and the molecular evidence of nosocomial transmission of this strain in a neonatal unit by enterovirus genotyping and phylogenetic analysis. This report illustrates the importance of including enterovirus genome detection in the sepsis screening concomitantly with bacteriological investigations performed at admission of a neonate. Rapid diagnosis and subsequent genotyping could have a beneficial impact on clinical practices at the individual level (reducing the length of antibiotic therapy) and public health policy at the collective level by reinforcing hygiene measures to prevent nosocomial infections, with nurseries and neonatal units being at greater risks. [Copyright &y& Elsevier]

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Abstract: The system used for compensating victims of nosocomial infections resulting from the laws of March 4 and December 30, 2002 is very positive, both in terms of the rules used to define the liability regimes and the procedure used by CRCIs (Regional Commissions for Conciliation and Compensation for Medical Accidents, Iatrogenic Disorders and Nosocomial Infections). However, it seems necessary to make some adjustments. Recent laws bound healthcare facilities and healthcare professionals to a different liability regime. While judicial case law prior to the law of March 4 bound clinics and independent practitioners to the same objective liability regime for a breach of duty in providing a safe outcome, infections occurring following care given in medical practitioners’ offices are now excluded from the ex officio liability regime laid down in Article L. 1142-1 of the public health code, and fall under the fault-based liability regime. A victim of healthcare-associated infection contracted during an intervention carried out in an independent clinic can only receive compensation if said victim can establish the occurrence of a breach, while the same victim would have received ex officio compensation if the same intervention had been performed in a healthcare facility. Bearing in mind that certain invasive medical acts do not require hospitalization, this difference in the treatment of victims who have undergone the same act raises the question of the need to widen the ex officio liability regime to infections contracted in practitioners’ offices. [Copyright &y& Elsevier]

Abstract: Objective: The aim of our study was to determine risk factors associated with nosocomial infections in children hospitalized for skin burn. Study design: Prospective study including children hospitalized for skin burn. Methods: We collected demographic characteristic, mode of admission, mechanism of burn, extent of burn surface by the tables of Lund and Browder, depth of the lesions according to clinical criteria and evolution, type of invasive care (urinary catheterization, central catheterization or mechanical ventilation), nosocomial infection and its time of occurrence, prescription of empirical antibiotic therapy and evolution during hospitalization. The criteria for “American Burn Association” were used to define a severe burn in children. Results: One hundred eighty-two children were included. In univariate analysis, six risk factors were significantly associated with the occurrence of nosocomial infection: extent of burn surface, severe burn, urinary catheterization and its duration and central catheterization and its duration. Extent of burn surface greater than 10% of total body surface is an independent factor of the occurrence of nosocomial infection (P =0.009) in Multivariate analysis. Conclusion: In our study, extent of burn surface greater than 10% of total body surface is as an independent risk factor for the occurrence of nosocomial infection. [Copyright &y& Elsevier]

Summary: Introduction: Stenotrophomonas maltophilia (S.M.) is a Gram-negative bacillus, naturally resistant to cephalosporins and carbapenems, which can colonize different sites and may be responsible for serious infections for which treatment is a real challenge. We report 2 cases of nosocomial S.M. infection in 2 hospitalized newborns in the neonatal intensive care unit. Case 1: A 3-day-old newborn presented with infection beginning in the respiratory system, treated with ciprofloxacin, and complicated by septicemia, resulting in death. Case 2: An 11-day-old newborn presented with brain S.M. suppuration: empyema and multiple abscesses were treated successfully with the combination of amikacin and chloramphenicol with good progression in the short and medium terms. Discussion: Some epidemiological studies report that S.M. is the second Gram-negative bacillus responsible for nosocomial infection after Klebsiella pneumoniae. While the respiratory location of the bacterium is typical, cerebral parenchyma damage is rare in the newborn. The treatment remains very delicate and difficult because of this bacterium''s drug multiresistance. Conclusion: These 2 cases of infection caused by S.M. including respiratory tract infection with bacteremia and cerebral suppuration in newborns have broadened the spectrum of diseases caused by this organism and are a reminder of the emergence of this organism and its natural resistance to several antibiotics. [Copyright &y& Elsevier]

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Copyright of Revue Francophone des Laboratoires is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of IRBM is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Summary: Accidental burns in the operating room are hopefully rare events, but it could happen during any surgical procedure. To reduce the nosocomial infection, the use of alcohol-base products is recommended by all the recent guidelines. Yet these inflammables products represent a potential danger if they are not carefully employed, and the surgeon''s responsibility can be involved. We therefore thought it would be interesting to show the benefit provided by such products in terms of wound infection and skin preparation. However, two recent cases of severe accidental burn illustrate the importance of precautions when using such products. [Copyright &y& Elsevier]

Summary: Background: The hygiene of hands stays the basic measure to reduce the incidence of the hospital-borne infections. Its importance is major in a service of neonatology. Our work aimed at estimating the knowledge and the practices on the hygiene of hands. Method: The study was realized at the level of the unit of neonatology and the intensive care of the service of infant medicine and neonatology of the north hospital of Marseille and took place from 1st till 15 August 2008. Results: We questioned 55 persons of the staff, seek attendants and observed 30 persons. Near the quarter of the staff (23.6%) think that the solutions hydro-alcoholic are less effective than the simple wash of hands and more half (the 51%) than they are less effective than the hygienic wash. In respectively 20% and 36% of the cases, the staff underestimates the duration of the procedure of wash of hands and the hydro-alcoholic friction. In 58.1% of the cases, the staff ignores that the hydro-alcoholic solutions can be used in all the situations where hands are not soiled. Attendants seems to have a good knowledge of the hydro-alcoholic solutions. They know the indication about it in 56.2% of the cases and think that they are effective in 50% of the cases. The staff seems to have a good theoretical knowledge (87.2 in 96.4%) measures of hygiene of hands to be before adopted and after the most current gestures in the unit. There is an inobservance of the hygiene of hands in 33.3% of the cases. None of the persons outside the service practised a measure of hygiene of hands. A bad quality of the wash of hands concerning the contagion at the end of procedure was found in 64.7% of the cases and it in all the observed categories. Conclusion: There is a real lack of information of the staff about the hygiene of hands. For the improvement of the quality of the care, the evaluation of the practices and the training of the staff turn out indispensable. [Copyright &y& Elsevier]

Abstract: The most frequent complications following percutaneous gastrostomies are those occurring around the tube insertion site (leakage, purulent secretions and excessive granulation tissue) or those involving deterioration of the gastrostomy tube. These complications are usually benign; rarely, peristomial wound infection can present as a necrotizing fasciitis. In most cases, local antiseptic care and antibiotherapy are sufficient to control peristomial wound infection. In case of systemic signs of infection, parenteral antibiotherapy is indicated. [Copyright &y& Elsevier]

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Copyright of Revue Francophone des Laboratoires is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Objective: A recent measles epidemic in France incited us to report and describe measles cases requiring hospitalization, to raise the awareness of health professionals on under-diagnosis and frequent complications of this viral disease. Design: We carried out a retrospective and epidemiologic study of measles cases recorded in the Nantes Teaching Hospital between August 2008 and September 2009. All these cases where confirmed by biological diagnosis and recorded by the Teaching Hospital virological laboratory. Results: Thirteen cases of measles (11 adults and two children) were recorded during the study period. Adults were young (mean age 21.4 years); the oldest was 35 years old. We noted two severe cases with viral pneumonia and hypoxemia and one case with bacterial pneumonia. Two female patients were pregnant; one delivered prematurely, in the acute phase of measles, with no complication for the newborn. Two cases occurred in the nursing staff by documented nosocomial transmission. Sixty-nine percent of the patients were not vaccinated whereas the vaccinal status was not documented for 31%. Conclusions: These cases underline the potential severity of this infection and the difficulty to diagnose measles at the early phase because of lack of awareness of medical staff. It will be necessary to reinforce prevention messages and promote measles vaccination in children as well as in young people and health workers. [Copyright &y& Elsevier]

Summary: Introduction: In Africa, with the technological advances of the last decade, the university hospital pediatric departments have optimized the management of newborns at the cost of a nosocomial risk premium. In Abidjan, in the service of neonatology, the prevalence of germs usually implicated in nosocomial infections was 33% with a predominance of gram negative bacilli (79%). Klebsiella pneumoniae and Enterobacter cloacae were the two most common germs. Nosocomial infection or maternal-fetal distinction was not made. Method: A retrospective cohort study was conducted over a period of seven years in the neonatal unit of university hospital of Yopougon in Abidjan. Purpose: Identify clinical signs suggestive of infection due to Klebsiella pneumoniae and Enterobacter cloacae and propose a clinical score of risk of nosocomial infection. The records of newborns with a positive blood culture for Klebsiella pneumoniae or Enterobacter cloacae were assessed under Center for Disease Control and Prevention suitable for newborns. Fever (31%), digestive signs (27%), respiratory distress (16%) and jaundice (13%) were the main signs identified. A clinical score for risk of nosocomial infection has been proposed based on signs and identified risk factors in our context. [ABSTRACT FROM AUTHOR]

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Abstract: Methicillin-resistant Staphylococcus aureus (MRSA) has long remained the typical exclusively nosocomial pathogen, allowing using betalactam agents as first line presumptive treatment for severe community-associated infections in which MRSA was not taken into account. The situation dramatically changed with the simultaneous emergence of several strains of community-acquired MRSA in Australia, Europe and in North America. Although these clones clearly emerged from independent ancestors, they present almost invariably with two remarkable features, rarely found in other MRSA clones: (i) methicillin-resistance genes are harboured on a small size staphylococcal cassette chromosome (SCCmec type IV); (ii) they are all transfected by a phage carrying Panton-Valentine leukocidin (PVL) genes. Since the early 2000, a specific clonal group, USA300, spread spectacularly all over North America. A great number of publications documented (i) the unprecedented success of its dissemination in many settings; (ii) its virulence, illustrated by the description of invasive diseases not encountered thus far with traditional clones of hospital-associated MRSA (e.g. necrotizing pneumonia in immunocompetent patients). In Europe, where community-acquired MRSA isolates mainly belong to the ST80 clonal group, its incidence has remained low, thus far. However, cautious surveillance and prompt responses are required if we are to avoid the public health scourge created by the emergence of community-associated MRSA in North America. [Copyright &y& Elsevier]

Abstract: Objective: A prospective observation study was undertaken in seven medical centers, in the French region Alpes-Maritime, to assess nail hygiene of healthcare professionals and how often they wear hand jewellery. Method: Seven hundred and six healthcare workers in seven medical centers were interviewed from March to April 2008. Results: Among the 706 professionals, 306 (43%) were wearing one or several pieces of jewellery. The nails of 81 (11.5%) were non-standard according to guidelines. Three hundred and forty-four health care professionals (49%) were wearing one or several pieces of jewellery and/or presented with non-standard nails. In univariate analysis, the wearing of jewellery was linked to the medical centre (P <0.001), to the professional category (p <0.001), to the number of times people washed their hands or used hand gel per day (ABHR) by categories (<10 times per day or ≥10 times per day) (P <0.017). In the multivariate analysis, the risk factors linked to the wearing of jewellery were the medical centers, the professional category, and the age. Conclusion: There are still too many healthcare professionals who do not comply to French recommendations on hand hygiene concerning the wearing of jewellery and nail hygiene standards. [Copyright &y& Elsevier]

Abstract: Objective: The study''s objective was to describe the evolution of antibiotic consumption between 2006 and 2008 in French health care facilities (HCF) its relations with the national policy of good antibiotics use using the ICATB score. Method: Data from standardized reports on infection control activities collected from 2006 to 2008 by the Ministry of Health (antibiotic consumptions and elements of antibiotic stewardship of every HCF) were analyzed with linear regression models to multilevel random intercept adjusted on HCF characteristics (public or private) and activity. Results: The analysis was performed on 4062 (48,2%) observations after exclusion of HCF not concerned by the ICATB public reporting indicator (7.2% of observations), invalid or missing data (21,2% of observations) and irrelevant values (23.4%). The global antibiotic consumption was 343 defined daily doses (DDD) per 1000 patient-days (PD) and varied little between 2006 and 2008. However, the linear regression model showed an increase of 5.7 DDD per 1000 PDs per year (P <0.001). There was a positive association between antibiotic consumption and ICATB score, mainly concerning sub-scores ICATB-action and ICATB-organization. Conclusion: The recent lack of decrease in antibiotic consumption in French HCF between 2006 and 2008 is coherent with other available national data, but exclusion of more than 50% of observations limits the impact of this analysis. The relationship between policy of good use and consumption of antibiotics remain difficult to specify, because of the short (three years) study length and because of the nature of ICATB, a composite indicator assessing only partly antibiotic policies. [Copyright &y& Elsevier]

Abstract: Objectives: The aim of this study is to evaluate the quality of disinfection of endoscopes at Brest hospital over a period from 2007 to 2009. Patients and methods: Retrospective study of microbiological investigations of endoscopes done at Brest hospital from 2007 to 2009. The interpretation of the microbiological investigations is based on the recommendations of the Comité technique national des infections nosocomiales et infections liées aux soins (CTINILS) of 2007. Results: Most of the controls realized over the period deal with gastroenterological endoscopes (63.4 %) and bronchial endoscopes (21.8 %). Most of the controls (66.8 %) are conformed to the target level. Only 26.7 % of the controls get the level of action. Globally, the rate of level of action significantly increases (p =0.004) from 2007 (21.2 %) to 2009 (35.6 %). This increase is relatively important in gastroenterology endoscopy (46.8 % in 2009 versus 24.1 % in 2007) whereas the rate decreases in bronchial endoscopy (14.8 % in 2009 versus 25.9 % in 2007). In gastroenterological endoscopy, rates vary with the type of endoscopes and the context of controls, but there is no significant difference between manual disinfection and automated disinfection. The most frequent germ found in gastroenterological and bronchial endoscopies is Pseudomonas aeruginosa. Conclusion: Our results show that it is very difficult to insure a perfect disinfection of endoscopes. Difficulties met are certainly related with the complexity of the endoscopes and of the techniques of disinfection. Infections of patients are very infrequent in endoscopy, which takes the question of the pertinence of the threshold used for microbiological investigations. [Copyright &y& Elsevier]

Abstract: Objectives: To describe the demographic characteristics, incidence of extra-abdominal hospital-acquired infections and outcome of patients admitted to intensive care unit (ICU) with severe acute pancreatitis. Study design: A retrospective, observational multiple center (65 centers) analysis of prospectively acquired data. Patients and methods: During 2 years, all consecutive admitted patients to ICU for severe acute pancreatitis in the centers participating in the nosocomial infections surveillance network CClin Sud-Est were included. Patients whose ICU stay was less than 48hours were not included. Demographic characteristics, extra-abdominal hospital-acquired infections and clinical course were described. Results: During the study period, 510 patients were included which represented 2 % of patients with a length of stay longer than 48hours in the 65 participating ICUs. The global attack rate of extra-abdominal hospital-acquired infections (pneumonia, bacteremia, urinary tract or central venous catheter infection) was 23 % in overall patients and it was 33 % in the 294 mechanically ventilated patients. ICU mortality was 20 % in overall patients and it was 34 % in mechanically ventilated patients. Conclusion: Severe acute pancreatitis represents 2 % of ICU stay longer than 48hours. Its clinical course is frequently complicated by hospital-acquired infections and is associated with an high ICU mortality rate. This epidemiological observational study may be used for calculating sample size for future multicenter interventional therapeutic studies. [Copyright &y& Elsevier]

Abstract: Objective: It was to determine the antibacterial spectrum of JCA 250 and JCA 251, two naturally occurring compounds from Aroma Technologies research, on a bacterial population isolated from clinical infections. Method: Two hundred and twenty-four bacterial strains were tested. The minimum inhibitory concentrations (MIC) of JCA 250 and JCA 251 were determined by agar dilution method. Tests were performed in triplicate. Results: The mean MIC was 0.20% for JCA 250 and 0.15% for JCA 251. JCA 251 regularly exhibited greater activity. All Enterobacteriaceae were inhibited at concentrations less or equal to 0.15% for JCA 250 or JCA 251. For strict aerobes, the MIC values were more spread out. Two Pseudomonas aeruginosa strains differed from the population with JCA 251 MIC of 0.25 and 0.40%. Concerning Gram-positive cocci, all the strains were inhibited with less or equal to 0.25% of compound. The most resistant population were the Enterococci and the Lactobacilli, with MIC more or equal to 0.2% for JCA 250 or JCA 251. Anaerobes showed MIC closely grouped for a heterogeneous bacterial group. One Propionibacterium sp. strain came apart from the group and was inhibited with a MIC of 0.5%. Conclusion: The overall results showed an interesting antibacterial activity on bacteria isolated from clinical samples. Most of the bacterial strains were inhibited at a concentration of 0.2%. The highest mean values were obtained for commensal bacteria from the flora, which is of particular interest in this study. [Copyright &y& Elsevier]

The article presents information on a survey concerning the relationship between nosocomial infection (NI), renal replacement therapy (RRT) for acute kidney injury (AKI) and mortality in intensive care unit (ICU). It informs that the patients were excluded on the basis of prior chronic dialysis, RRT without AKI and plasma exchange, during the survey. The survey found that the relationship between NI, RRT and AKI is complicated.

Abstract: Controlling the diffusion of multiresistant bacteria is a priority in the campaign against nosocomial infections. Geriatric units seem to be reservoirs of methicillin-resistant Staphylococcus aureus (MRSA). Objective: The first objective of this study was to determine if some characteristics identified on admission in a rehabilitation care unit could influence the colonization by the bacterium, and to define the rate of importation and acquired-infections. The second objective was to evaluate the preventive effects of enhanced cleaning with hydro-alcoholic solution, in comparison with our previous study made five years before. Method: One hundred and eighty-eight patients (mean age, 83.75±7.35years) were included. Results: The rates of importation and colonization were respectively of 22.4% and 25.5%. The predictive factors of acquisition were dependence, malnutrition, presence of urinary catheter, and chronic wounds. The comparison with data collected five years earlier showed a reduction of colonization rates from 44 to 25%. Comments: Our study highlights the important role of hand contamination in colonization of the MRSA especially for dependant patients, and shows the importance of hand-hygiene compliance, as well as maintaining autonomy among old patients. The use of hydro-alcoholic solution in association with the reinforcement of hospital hygiene measures led to the decrease of acquired-infection rate. [Copyright &y& Elsevier]

Objective: Nosocomial infections are a major public health concern not really under control in at-risk health care services such as maternity and neonatology. Material and methods: Initiated by the committee against nosocomial infection (CLIN) established in Principal Hospital in Dakar, a prevalence survey was conducted 'on a given day' every year in June in all the services of the hospital. Our study is a review of four-year prevalence survey from 2005 to 2008 on women who had given birth and on newborns. The survey included all hospitalized patients except those admitted the same day. Results: In maternity service, among the 69 women who had given birth, 16 delivered by caesarean section. None of these women had nosocomial infection. Among the 74 newborns included the neonatology service, 3 nosocomial infections (in 2 males and 1 female) were detected, with a prevalence rate of 4.05%. The identified nosocomial infections were 2 cases of sepsis and 1 case of omphalitis. The bacteria isolated were Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Enterobacter spp. which were multiresistant to antibiotics. Through therapy, the infected newborns' health had improved significantly. Conclusion: The method of investigation for prevalence survey 'on a given day' gives an overview of the prevalence of nosocomial infections in health care structures, and thus improves the quality of care. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To determine the incidence of catheter-related bacteremia (CRB) in a Moroccan medical intensive care unit, the microbiological profile of this infection and risk factors associated with its occurrence. Study design: Prospective observational study. Methods: Over a period of 8 months, patients who required central venous catheter (CVC) placement for a duration greater than 48h were included in the study. The CRB has been defined by the criteria of the SRLF Consensus Conference. The proportions of colonization and CRB were expressed as incidence density (ID). Risk factors for colonization were studied in univariate analysis. Results: One hundred and two CVC were inserted in 70 patients. The average age was 54±20 years with an APACHE II of 28±10. The ID of colonization and CRB were respectively 34 for 1000 days of CVC use and 8 for 1000 days of CVC use. The isolated microorganisms were Gram-negative bacilli in 73 %, Gram-positive cocci in 22 % and finally yeast in 5 %. A prolonged duration of catheterization and the absence of systemic antibiotic therapy before catheterization were the main risk factors for colonization. Conclusion: The incidence of CRB was high. These results impose a reflection of the care team to improve protocols for prevention of such nosocomial infections. [Copyright &y& Elsevier]