Wearing gloves: the worst enemy of hand hygiene?

International audienc

Optimisation de la rentabilité du dépistage des patients porteurs de Staphylococcus aureus resistant à la méticilline (SARM) dans les services de soins de court séjour hors soins intensifs

Date du colloque&nbsp;: 06/2008</p

A clandestine worm

International audienc

Methicillin-resistant Staphylococcus aureus (MRSA) in the institutionalized older patient

SummaryNursing homes and long-term care facilities are usually considered as reservoirs for methicillin-resistant Staphylococcus aureus (MRSA) carriers. Actually, there are major differences in MRSA carriage between institutions, with variations from 1% to more than 30%. Overall there is a low incidence of MRSA infection in these institutions, even though carriage is associated with a higher risk of subsequent MRSA infection, with high mortality rates. The main risk factors for carriage are well known: recent hospitalization in an acute-care ward, skin wounds and recent antimicrobial therapy. Age over 75 years is also a risk factor. Residents of nursing homes and long-term care facilities pose a risk of MRSA transfer to acute-care wards, with potential consequences in terms of infection control strategy or surgical antibiotic prophylaxis. No well-designed study has identified the best strategy for MRSA control in institutions for older people and strategies that have been proposed are controversial. Studies to elucidate this would be useful, as well as studies specifically designed to identify the relative importance of different ways of MRSA transmission in these institutions (cross-transmission via healthcare workers or the environment, or direct transmission from one resident to another). Finally, a first important step towards MRSA control is a strict application of standard precautions, particularly good compliance with hand hygiene

Infections émergentes à Acinetobacter baumannii et circonstances favorisant leur survenue

During the last decade, Acinetobacter baumannii (AB) has been increasingly responsible for infections occurring in three particular contexts (in terms of patients and environment). Community AB pneumonia is severe infections, mainly described around the Indian Ocean, and which mainly concern patients with major co-morbidities. AB is also responsible for infections occurring among soldiers wounded in action during operations conducted in Iraq or Afghanistan. Lastly, this bacterium is responsible for infections occurring among casualties from natural disasters like earthquakes and tsunamis. Those infections are often due to multidrug-resistant strains, which can be implicated in nosocomial outbreaks when patients are hospitalized in a local casualty department or during their repatriation thereafter. The source of the contaminations which lead to AB infections following injuries (warfare or natural disasters) is still poorly known. Three hypotheses are usually considered: a contamination of wounds with environmental bacteria, a wound contamination from a previous cutaneous or oropharyngeal endogenous reservoir, or hospital acquisition. The implication of telluric or agricultural primary reservoirs in human AB infections is a common hypothesis which remains to be demonstrated by further specifically designed studies

Correlation between glove use practices and compliance with hand hygiene in a multicenter study with elderly patients

In a study conducted in 11 health care settings for elderly patients, we demonstrated a significant negative correlation between the proportion of glove use outside any risk of exposure to body fluids and compliance with hand hygiene (P &lt; .02). This result underscores a major limitation of strategies for controlling the spread of multidrug-resistant bacteria that recommend systematic glove use for each contact with carriers or their environment

Étude de la sensibilité de 224 bactéries isolées d’infections hospitalières vis-à-vis des composés JCA 250 et JCA 251 à base d’huiles essentielles issus de la recherche Aroma Technologies

But de l’étudeIl a été de déterminer le spectre antibactérien de JCA 250 et JCA 251, deux substances d’origine naturelle issues de la recherche Aroma Technologies, sur une population bactérienne provenant d’infections cliniques. Méthode Deux cent vingt-quatre souches bactériennes ont été testées. Les concentrations minimales inhibitrices (CMI) des composés JCA 250 et JCA 251 ont été déterminées par la méthode en milieu gélosé. Les tests ont été réalisés en triple. Résultats La valeur moyenne des CMI était de 0,20 % pour JCA 250 et de 0,15 % pour JCA 251. JCA 251 présentait régulièrement une meilleure activité. Toutes les entérobactéries étaient inhibées à des concentrations inférieures ou égales à 0,15 % pour JCA 250 ou 251. Pour les aérobies stricts, les valeurs des CMI étaient plus étalées. Deux souches de Pseudomonas aeruginosa se distinguaient de la population avec des CMI de JCA 251 de 0,25 % et 0,40 %. Chez les cocci à Gram positif, les souches bactériennes étaient toutes inhibées par des concentrations inférieures ou égales à 0,25 %. Les populations les plus résistantes étaient les entérocoques et les lactobacilles, avec des CMI supérieures ou égales à 0,20 % vis-à-vis de JCA 250 et JCA 251. Les anaérobies présentaient des CMI très voisines pour un groupe bactérien hétérogène. Une souche de Propionibacterium sp. se détachait du groupe et était inhibée à des concentrations de 0,5 %. Conclusion L’ensemble des résultats ont montré une activité antibactérienne intéressante sur les bactéries isolées de prélèvements cliniques. La plupart des souches étaient inhibées par des concentrations de 0,2 %. Les valeurs moyennes les plus élevées étaient obtenues avec des bactéries commensales de la flore, ce qui est un aspect particulièrement intéressant à exploiter dans cette étude

Rates of Adherence to Hand Hygiene and Gloving Practices in 2 French Rehabilitation Hospitals by Differentiation between Single Contacts and Series of Successive Contacts with Patients or the Environment

International audienc

Colistin, rifampicin, and meropenem administered as single agents in a model of pneumonia caused by a carbapenem-resistant Acinetobacter baumannii

International audienc