[Prevalence of nosocomial infections in 27 hospitals in the Mediterranean region]. / Prévalence des infections nosocomiales dans 27 hôpitaux de la région Méditerranéenne.

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 > or = 8 days, presence of a central or peripheral catheter), urinary catheter, diabetes and age.

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

Multicenter pilot survey of resistant bacteria in the Mediterranean area.

With the aim of testing the feasibility of a multiresistant bacteria (MRB) surveillance methodology and evaluating the level of antimicrobial resistance and dissemination of resistant pathogens in the Mediterranean area, a pilot study was carried out in nine university hospitals in Algeria, Tunisia and France. The results indicate that third-generation cephalosporin-resistant Enterobacteriaceae comprise the major MRB in Algerian and Tunisian hospitals. In France, the highest incidence rates were found for methicillin-resistant Staphylococcus aureus, while in Tunisian hospitals, imipenem-resistant Acinetobacter baumannii seems to be a particularly prevalent organism. Although the data were not representative of the participating countries as a whole, the results show the importance and ubiquity of the problem in the area and the feasibility of surveillance.

Multicentre study on hand hygiene facilities and practice in the Mediterranean area: results from the NosoMed Network.

Hand hygiene literature is scarce in the southern Mediterranean area. In order to establish a baseline position, a study was performed in four Mediterranean countries. Seventy-seven hospital wards in 22 hospitals were enrolled and information on hand hygiene practice and facilities were collected. The overall compliance rate was very low (27.6%), and was significantly higher where the perceived risk was considered to be high. Intensive care units showed the highest level of compliance. Analysis by country indicated higher compliance in Egypt (52.8%) and Tunisia (32.3%) compared with Algeria (18.6%) and Morocco (16.9%). Facilities for hand hygiene, particularly consumables, were shown to be deficient. Multi-approach programmes combining the production of official local recommendations, education and regular evaluation of hand hygiene practice are much needed to improve the present situation.

Better compliance and better tolerance in relation to a well-conducted introduction to rub-in hand disinfection.

The aim of the study was to demonstrate that the introduction of rub-in hand disinfection (RHD) in hospital units, with the implementation of suitable equipment, drafting of specific protocols, and training users, improved compliance of hand disinfection and tolerance of user's hands. In four hospital units not previously using RHD an external investigator conducted two identical studies in order to measure the rate of compliance with, and the quality of, disinfection practices, [rate of adapted (i.e., appropriate) procedures, rate of correct (i.e., properly performed) procedures, rate of adapted and correct procedures carried out] and to assess the state of hands (clinical scores of dryness and irritation, measuring hydration with a corneometer). Between the two studies, the units were equipped with dispensers for RHD products and staff were trained. Compliance improved from 62.2 to 66.5%, quality was improved (rate of adapted procedures from 66.8% to 84.3%, P > or = 10(-6), rate of correct procedures from 11.1% to 28.9%, P > or = 10(-8), rate of adapted and correct procedures from 6.0 to 17.8%, P > or = 10(-8)). The tolerance was improved significantly (P > or = 10(-2)) for clinical dryness and irritation scores, although not significantly for measurements using a corneometer. This study shows the benefit of introducing RHD with a technical and educational accompaniment.