[Bacteriological control of food for immunocompromised host]. / Contrôle bactériologique des aliments pour immuno-déprimés.

This study concerning bacteriological controls of food for immuno-suppressive patients have shown that food sterilized in sterilizer or with pressure-cooker contains sporulated bacteria after treatment. Unit packaging or freeze-drying commercial foods offer no bacteriological quality guarantees. Clinicians have to define acceptable contamination rate according to their patients' condition.

[Does automatized disinfection of traps by chlorine reduce water related contamination?]. / La désinfection automatisée des siphons par le chlore réduit-elle la contamination d'origine hydrique?

Sanitary U bends are very contaminated places from a microbiological point of view. They may even be dangerous for immunocompromised patients. Although daily chloride disinfection of U-bends is ineffective, it seems to work when performed after each use of sanitary devices. On line disinfection reduces not only U-bend bacteriological contamination but also all surrounding surfaces.

[Prevention of exogenous respiratory infection]. / La prévention de l'infection respiratoire exogène.

The exogenous respiratory infections have two transmission channels, the airborne and the handborne ways, and two entrance doors, tracheotomy and intubation. Indeed, most often, contamination of the oropharynx occurs prior to the bacterial pneumonia. These microorganisms are isolated on healthy carries, on linen, furniture, air-conditioning system and so on... Special precautions are recommended as disinfection or sterilization of ventilators equipment changing circuits every 48 hours, using sterile water in humidifiers, and rigorous aseptic technic for tracheal suctions. An experimental study shows that microorganisms present in the humidifier disseminate through the circuit with the airstream. Therefore septic isolation of patients with pneumonia and disinfection of the room after his departure are considered as essential measure of prevention.

[Evaluation of the cost-efficacy ratio of Pall BB 22 15 filters for the bacterial protection of anesthesia circuits]. / Evaluation du rapport coût-efficacité des filtres Pall BB 22 15 dans la protection bactérienne des circuits d'anesthésie.

The aim of this study is to assess wether the use of the bacteriological filter Pall BB 22 15 placed on the Y piece of the anesthesia equipment decreases contamination and furthermore to evaluate the cost of this practice versus changing anesthetic circuits after every patient. Randomized trials are conducted with three "Engström" machines in three cardiac surgery operating rooms. The Y pieces were examined with qualitative and quantitative bacteriological analysis. Use filters is less expensive than changing circuit for each patient for a comparable efficacy.

[Infectious enterocolitis in intensive care patients fed by nasogastric tube]. / Entérocolites infectieuses chez des malades de réanimation alimentés par sonde nasogastrique.

Infectious enterocolitis sometimes spreads through intensive care units, the origin being contamination by "drips". A 9 month study concerning patients fed by nasogastric "drip" revealed 70 p. 100 of cases of severe diarrhea. Stool cultures confirmed the infectious origin of this diarrhea in 66 p. 100 cases. Virtually all of the suspect drip containers and fluids contained the organisms found in the stool culture, with a concentration of 10(6)-10(9) per ml/foodstuff. Enquiry revealed that contamination of these drips occurred above all in the kitchen at the time of preparation (poorly washed material, personnel often unaware of elementary hygiene). The great vulnérability of such intensive care patients predisposes them to infection of this type and the limit of danger for them is as low as 10(4) organisms per ml/foodstuff. Solutions concerning hygiene in preparation were tried with success (drips then containing only 50-100 organisms per ml/foodstuff.

[Mortality factors in infectious diseases in a surgical intensive care unit]. / Etude des facteurs de mortalité infectieuse dans un service de réanimation chirurgicale.

Among 350 patients admitted to a surgical intensive care unit between 1.1.77 and 31.9.77, their profile and septic course being defined, two populations were studied: -- the first involved 49 patients dying of infection during their stay in the department; -- the second involved 132 patients developing a non lethal infectious syndrome. Comparative study of these two patients groups made it easier to understand why, in the same department and apparently with the same kind of care, certain patients die of infection and others do not. It was thus attempted to demonstrate certain difference between the two groups in terms of biometric data, predictable risk factors, the type of underlying pathology and the nature and course of the infectious process. Finally, the role played by the intensive care unit in the onset of these deaths of infectious cause is considered.