Prevalence of nosocomial infections in 27 hospitals in the Mediterranean region

A multicentre study was conducted in 27 hospitals in Algeria, Egypt, Italy, Morocco and Tunisia to evaluate the prevalence and characteristics of the nosocomial infections. The study population [4634 patients] was relatively young, mean age 41.1 [standard deviation 23.4] years. The prevalence of nosocomial infections was 10.5%; this was higher in non-teaching centres and moderate-sized hospitals. Overall, urinary tract infections were the most common. Paediatric departments rated particularly high [11.3%]. The most commonly isolated organisms were: Escherichia coli [17.2%], Staphylococcus aureus [12.5%], Pseudomonas aeruginosa and Klebsiella pneumoniae [9.2% each]. On the day of the study, 40.7% of the patients were under treatment with antibiotics, with nearly half for an empirical indication. Nosocomial infection was significantly associated with mechanical ventilation, hospitalization ? 8 days, presence of a central or peripheral catheter], urinary catheter, diabetes and age

Seroprevalence of hepatitis C virus infection in diabetic patients

Hepatitis C virus [HCV] infection primarily causes liver disease but also various extrahepatic manifestations. The association of chronic HCV infection and diabetes mellitus has been recently reported. The aim of this study is to investigate the prevalence of HCV infection in diabetes patients. This study included 100 diabetic patients and 300 group control patients consulting in various diagnostic centers. Serum samples were tested for anti-hepatitis C virus antibody [HCV Ab], total HBc antibody and for hepatitis B antigen [HBs Ag]. Anti HCV were detected in 6 diabetic patients and 2 controls [6% vs 0.67%, p=0.001]. And 5/6 HCV Ab positives patients had type 2 diabetes mellitus. HBs Ag and anti HBc were detected respectively in 1% and 49% in diabetic patients. Our study shows an increasing seroprevalence of HCV Ab in diabetic patients that allows us to define them as a group at risk for viral hepatitis C

Ataxia telangietasia [about 11 cases]

Ataxia telangiectasia [AT] is an autosomal recessive disorder, caracterized by progressive cerebellar ataxia, oculocutaneos telangiectasia, immunological abnormalities and increased susceptibility of malignancies. Our study objectives are to provide the last data in genetic, clinical and therapeutic fields concerning AT in order to help our doctors to establish the diagnosis in the first stages and so participite to the diagnosis of the primary immunodeficiency diseases. Our 11 patients are from 7 families and the consanguinity was found in 8 cases. The median age of diagnosis is about 7 years and 7 months. The clinical study had found out eight cases of manifest ataxia, nine times bulbar telangiectasias and eight cases of bronchectasias. On the immunological side, the serum IgA deficiency was found 5 times and one case had showed lymphopenia. The taking in charge consisted in infectious episodes treatement and continuous antibiotic prophylaxis, IGIV infusion was used only four times. The course of our patients was characterized by regression of infectious signs in five cases and the death of five others. One patient had never been seen again. Our set was charactezed by the heterogenecity of the features. In one hand we had severe form with a very soon start and in the other hand we had a mild clinical form with a late start

[Primary immunodeficiency in children in Casablanca: a 73 cases report]

Primary immunodeficiencies [PID] seem to have two particularities in the Maghreb countries: a higher frequency than in the occidental countries and a higher proportion of deficiency of HLA class II antigens. Patients and method: a four-year study reports 73 PID cases between 1997 March and 2001 February in the Clinical Immunology Unit of the Casablanca Children Hospital. These 73 cases were diagnosed, according to the WHO criteria, among 358 children with recurrent and/or severe infections. They had an immunological assessment: tuberculin IDR, blood cells, serum immunoglobulin A G and M, lymphocytes classes. we found 18 combined immunodeficiency including 5 deficiencies of HLA class II antigens, 18 antibody defects, 17 complex immunodeficiencies including 11 ataxia-telangiectasia syndromes, 13 PID associated to an other disorder including 4 hyper IgM syndrome, 6 phagocyte disorders and one complement defect. Because of their high cost, the intravenous immunoglobulins were used in only 29 children and the bone marrow transplantation is not available in our country. Twenty six children died in this study. Comments: as in Tunisia, our study confirms the high frequency of combined and complex PID in comparison to the occidental studies, and we have to develop the PID diagnostic and treatment resources in our country