[Norovirus nosocomial outbreak : an hospital experience]. / Epidémie nosocomiale à norovirus : à propos d'une expérience hospitalière.

Human noroviruses (NoV) are the main pathogenic agents worldwide responsible for viral sporadic and epidemic gastroenteritis worldwide. A gastroenteritis outbreak broke out in patients hospitalized in several wards located in two different floors of a hospital in Liege, Belgium. The objective was to determine whether a same NoV strain would be involved in the two different floors, and to explore how this outbreak would have spread from a floor to the other. Stool samples from patients and healthcare workers were collected, as well as data from medical files. NoV detection, quantification and characterization were performed using molecular biology methods. A same NoV strain, from genotype GII.4, was detected in two patients hospitalized on the two different floors. This finding allowed to conclude that a same outbreak spread in the two floors, probably due to movements of common healthcare workers. A rapid NoV detection during outbreak is important in the aim to rapidly implement hygiene measures to limit the size of the outbreak.

Les norovirus humains (NoV) sont reconnus mondialement comme les principaux agents étiologiques de gastro-entérites virales sporadiques et épidémiques au niveau mondial. Une épidémie de gastro-entérites s'est déclarée chez des patients hospitalisés dans plusieurs salles d'un hôpital de la région liégeoise, situées à deux étages différents. L'objectif était de déterminer si une même souche de NoV était impliquée aux deux étages, et d'investiguer la manière dont l'épidémie se serait propagée d'un étage à l'autre. Des prélèvements ont été collectés chez les patients et le personnel soignant. Les dossiers médicaux ont été examinés. La détection, la quantification et la caractérisation des souches de NoV ont été réalisées par des méthodes de biologie moléculaire. Une même souche de NoV, du génotype GII.4, a été mise en évidence chez deux patients hospitalisés aux deux étages différents. Ce résultat indique qu'il s'agit de la même épidémie qui s'est étendue à deux étages, probablement transmise par l'intermédiaire du personnel soignant commun. L'identification précoce des NoV lors des épidémies est primordiale afin de mettre en place rapidement les mesures d'hygiène permettant de limiter leur propagation.

[Practical problems related to the management of febrile urinary tract infection in Vietnamese children]. / Difficultés de prise en charge des infections urinaires fébriles chez l'enfant vietnamien.

BACKGROUND: To describe the practical problems related to urinary tract infection (UTI) management in febrile Vietnamese children. METHODS: During a prospective 28-month inclusion period, 143 febrile children with significant bacteriuria were treated for UTI in the nephrology department of Nhi Dong 2 children's hospital in Ho Chi Minh City, Vietnam. Patients were treated after blood and urine samples had been taken for culture, according to a local antibiotic protocol, parenterally with ceftriaxone 75mg/kg/day. Oral treatment with cefixime 8mg/kg/day was started after 48h of apyrexia for 2 weeks. According to local protocol, antibiotic therapy was only changed if children did not respond clinically to treatment regardless of antibiogram results. RESULTS: Among these 143 children, 51% were girls and 80% of them had their first UTI before the age of 2 years. The commonest causative agent was Escherichia coli (80% of cases) with a high resistance rate to ampicillin (91%) and cotrimoxazole (74%). Extended-spectrum ß-lactamase (ESBL) production was observed in 52% of Enterobacteriaceae isolates. According to antibiotic susceptibility, the initial treatment with ceftriaxone was found to be inappropriate in 63% of cases. CONCLUSIONS: E. coli was responsible for 80% of UTIs in Vietnamese children with a high rate of resistance to first-line antibiotics. ESBL production was found to be extremely high in this study. Based on these data, we propose a new empiric treatment schedule for Vietnamese children suspected of UTI.

Prevalence and spread of extended-spectrum ß-lactamase-producing Enterobacteriaceae in Ngaoundere, Cameroon.

During April 2010 and June 2010, 334 Enterobacteriaceae isolates from 590 participants (outpatients, inpatients, inpatient carers, hospital workers and members of their households) were collected from faecal samples. Based on ß-lactamase pattern, origin of strains and the relationship between participants, 44 isolates of extended-spectrum ß-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae were selected from 44 participants (in Ngaoundere Protestant Hospital and Ngaoundere Regional Hospital, Cameroon). To determine the relatedness of bacterial strains, these isolates were fingerprinted using the automated, repetitive-sequenced-based PCR-based DiversiLab system. Subsequently, E. coli isolates that had undergone DiversiLab analysis were examined with respect to their phylogenetic group and detection of the ST131 clone to shed light on the epidemiology of these isolates in the Ngaoundere hospitals. The prevalence of faecal carriage of ESBL-producing Enterobacteriaceae among the study participants was 54.06%. According to participant groups, the prevalence of faecal carriage was also high (outpatients 45%; inpatients 67%; inpatient carers 57%; hospital workers 44%; and members of their households 46%). Analysis of the molecular epidemiology of ESBL-producing E. coli and K. pneumoniae showed a close relationship of the isolates between related and non-related individuals. In addition, DiversiLab results of E. coli identified four related isolates (4/22) from cluster III belonging to the epidemiologically important clone ST131. Our results highlight the importance of outpatients, inpatients, their carers, hospital workers and their families as reservoirs of ESBL-producing Enterobacteriaceae.

Extended-spectrum ß-lactamase-producing Enterobacteriaceae in Cameroonian hospitals.

Extended-spectrum ß-lactamase (ESBL)-producing Enterobacteriaceae have been described worldwide, but there are few reports on the carriage of these bacteria in Cameroon. In order to investigate the types of ESBLs and to analyse some risk factors associated with ESBL carriage, faecal samples were collected between 3 January and 3 April 2009 from hospitalised patients at Yaounde Central Hospital and at two hospitals in Ngaoundere, Cameroon. Enterobacterial isolates resistant to third-generation cephalosporins were screened for ESBL production using the double-disk synergy test. Polymerase chain reaction (PCR) and DNA sequencing were performed in order to find out the different types of ESBL genes in presumptive ESBL-positive isolates. During the study period, a total of 121 different patients were screened for ESBL carriage. The prevalence among these patients whose faecal samples were found to contain ESBL-producers was 55.3 % (67/121). According to a univariate analysis, hospitalisation during the previous year was found to be associated with ESBL carriage. Of the 71 bacteria isolated, Escherichia coli was predominant and represented 48 % of all isolates. ESBL characterisation revealed two types of ESBLs, CTX-M-15 (96 %) and SHV-12 (4 %). The present study emphasises the importance of screening for ESBLs in laboratories in African countries. The monitoring and detection of ESBL-producing bacteria are important in the setting up of appropriate treatment of patients and to ensure effective infection control efforts.

Acute cholecystitis with Listeria monocytogenes.

Listeriosis, an opportunistic food-borne disease caused by Listeria monocytogenes, is infrequent and occurs preferentially in patients at the extremes of age, during pregnancy or in immunocompromised hosts. Most common manifestations are maternofoetal and neonatal infections, severe invasive presentations such as bacteraemia with or without central nervous system symptoms occuring preferentially in immunosuppressed patients and self-limited gastro-enteritis affecting healthy individuals. Exceptionally, focal infections such as cholecystitis are described. We report here a case of acute cholecystitis caused by Listeria monocytogenes in an 82-year-old woman. Thanks to a successful treatment: cholecystectomy and antimicrobial therapy (amoxicillin plus clavulanic acid), the patient soon recovered. This case-report provides an opportunity to review the current literature concerning the association of Listeria monocytogenes and cholecystitis.

Epidemiologie moleculaire des betalactamases a spectre elargi produites par des Enterobacteriaceae d'origine fecale isolees chez les habitants de residences estudiantines a l'Universite de Kinshasa (RDC)

Objectif : Determiner l'epidemiologie moleculaire des Enterobacteriaceae productrices des betalactamases a spectre elargi (E-BLSE) chez les habitants de residence estudiantines a l'Universite de Kinshasa. Methodes : Des echantillons de selles preleves chez 516 etudiants ont ete examines pendant la periode du 15 novembre 2005 au 30 avril 2006. A l'aide de la galerie API 20E; nous avons pu identifier les differentes souches d'enterobacteries. La production de BLSE a ete recherchee par le test de synergie en double disque; puis confirmee et caracterisee par la focalisation isoelectrique; la PCR et le sequencage des genes de resistance. Un questionnaire a permis de recueillir les informations sur la demographie et les antecedents d'antibiotherapie des sujets inclus dans l'etude. Resultats : La frequence des E- BLSE etait de 17;8chez ces etudiants. Aucune correlation n'a ete notee entre un antecedent d'antibiotherapie et la presence d'E-BLSE. Parmi les E-BLSE isolees; Escherichia coli etait l'espece majoritaire (65); suivi de Klebsiella pneumoniae (26) etn d'Enterobacter cloaceae (5;4). CTX-M-15 etait l'ESBL predominante (29); suivie de CTX-M-28 (19;6); TEM- 68 (16;8); TEM-104 (9;3); CTX-M-3 (9;3); CTX-M-n 22 (4;7) ; SHV-12 (4;7); TEM-168 (1;9); TEM-144 (0;9); SHV-5 (0;9); SHV-2 (0;9); CTX-M-34 (0;9); CTX-M-62 (0;9). CTX-M-15 etait presente dans toutes les souches d'Escherichia coli isolees. Conclusion : Cette etude est; a notre connaissance; la premiere sur l'epidemiologie et la caracterisation des BLSE en RDC. La frequence des E-BLSE dans les residences estudiantines de l'Universite de Kinshasa; ainsi que la presence d'une grande variete de BLSE; justifieraient l'extension de ce type d'enquete dans la communaute et en milieu hospitalier; afin d'evaluer l'ampleur reelle du probleme et de definir des strategies adequates de pharmacovigilance et de lutte contre les bacteries multiresistantes aux antibiotiques

Evaluation of 13 selected medicinal plants from Burkina Faso for their antiplasmodial properties.

AIM OF THE STUDY: The aim of this study was to evaluate the antiplasmodial properties of 13 plants used against malaria in traditional medicine in Burkina Faso. MATERIALS AND METHODS: In vitro antiplasmodial activity of dichloromethane, methanol and aqueous crude extracts obtained from vegetal samples collected in Burkina Faso was first evaluated on the Plasmodium falciparum 3D7 chloroquine-sensitive strain using a colorimetric method. RESULTS: Thirteen extracts obtained from 8 different species were found to exhibit antiplasmodial activity (IC(50)<50 microg/ml). Five species demonstrated a moderate activity (15 microg/ml

[Re-emergence of human African trypanosomiasis in Kinshasa, Democratic Republic of Congo (DRC)]. / Réémergence de la trypanosomiase humaine africaine dans la province ville de Kinshasa, République démocratique du Congo (RDC).

BACKGROUND: The incidence of human African trypanosomiasis (HAT) or sleeping sickness in Kinshasa has been increasing since 1996. The objectives of this study were first to identify the optimal levels of knowledge, and then to determine the risk factors for HAT in the city of Kinshasa. METHODS: This case/control study was based on a structured questionnaire. Case-patients were detected and treated between 1 January 2004 and 31 December 2005. Each case-patient was paired with two seronegative controls of the same age and sex, living in the same type of environment. The study included 437 case-patients and 874 controls. RESULTS: The optimal level of knowledge defined by the list of elementary notions related to HAT was 44% for the case-patients and 37.0% for controls (p<0.0001). The majority of individuals (86.7%) was favorable to passive screening. The patients living in peripheral areas were more at risk than other groups, in rural areas (odds-ratio 12.1; 95% IC: 5.7-21.7), and remote areas (odds-ratio 8.9; 9% IC: 2.1-38.8). A family history of HAT (odds-ratio 12.9; 95% IC: 7.9-20.8), ignoring the transmission route (odds-ratio 11.2; 95% IC: 5.8-21.7), and the water supply in natural points (odds-ratio 6.9; 95% IC: 2.8-17.2) were also risk factors. CONCLUSION: The results identified avoidable factors, which could be taken into account, to decrease the incidence of new contamination, the morbidity, and mortality of HAT.

[MALDI-TOF mass spectrometry in clinical bacteriology or how to identify a bacteria within one minute]. / Spectrométrie de masse MALDI-TOF en bactériologie clinique ou comment identifier une bactérie en une minute.

The major application of MALDI-TOF mass spectrometry in clinical microbiology is the bacterial identification based on the analysis of all their proteins (ribosomal and membrane-associated proteins). This technology allows the identification of most of bacteria within a few minutes. The method is fast, accurate, reliable and cost-effective by comparison to conventional phenotypic techniques. Other applications of MALDI-TOF mass spectrometry are still under development, as the detection of bacterial toxins or resistance mechanisms to antimicrobial agents.

[Self-medication with antibiotics obtained from private pharmacies in Abidjan, Ivory Coast]. / Automédication par les antibiotiques provenant des pharmacies privées de la ville d'Abidjan en Côte d'Ivoire.

UNLABELLED: Self-medication with antibiotics is all the more disturbing in developing countries where this type of medication is easily available, and often without any prescription. OBJECTIVES: The authors wanted to assess and describe self-medication with antibiotics and identify the factors and public perception associated with this type of self-medication. PATIENTS AND METHODS: Eighteen private pharmacies were randomly selected in Abidjan. Data was collected through structured questionnaires and reports. Group meetings were organized for private pharmacy clients and the pharmacy staff. RESULTS: Two hundred and forty-two out of 1,123 purchases of antibiotics were for self-medication (21.5 %). Out of the 1,765 people interviewed, 1,054 (59.7 %) had bought antibiotics for self-medication in the 12 months prior to our study. Pharmacy staff very rarely provided any information to purchasers concerning dose, when to take the medicine, or treatment duration. A logistic regression analysis showed that the probability of self-medication with antibiotics increased with several factors: age, education level, and the possibility of purchasing antibiotics on the marketplace. However, this risk decreased when patients were covered by medical insurance, when the public perceived the risks of self-medication, and when bacterial resistance was clearly defined. CONCLUSIONS: This study was the first in the Ivory Coast to analyze the factors involved in antibiotic self-medication. It stressed the need to establish sustainable interventions to control the antibiotic use.

[Epidemiological, clinical and sociodemographic characteristics of human African trypanosomiasis (HAT) in and around Kinshasa, Democratic Republic of Congo]. / Caractéristiques épidémiologiques, cliniques et sociodémographiques de la trypanosomiase humaine africaine (THA) dans la région de Kinshasa, République démocratique du Congo.

BACKGROUND: Despite efforts to control human African trypanosomiasis (HAT) in the field, this infection remains prevalent in endemic or epidemic form in most of its traditional habitats. In the Democratic Republic of Congo (DRC), HAT has extended beyond rural areas to reach large cities such as Kinshasa. The objective of this study was to analyse the characteristics of trypanosomiasis patients (cases) in Kinshasa and to compare them to those of healthy controls. METHODS AND POPULATION OF STUDY: This case-control study allowed us to compare case patients and controls for some epidemiologic, clinical and sociodemographic characteristics. In all, 1764 people (588 case-patients and 1176 controls) were interviewed according to a structured questionnaire. Case-patients were infected with trypanosomiasis and entered the National Human African Trypanosomiasis Program (PNLTHA-DRC) from January 2004 through December 2005. Controls were matched for sex, age and residence to the corresponding case-patient, but had negative results from the Card Agglutination Trypanosomiasis Test (CATT-Test) whole-blood serologic analysis. Each patient was matched with two controls. RESULTS: Cases were identified in all 24 districts of Kinshasa, but were concentrated in the outskirts (outlying areas and southern expansion) and in rural areas. Overall, 25% (144/588) of case-patients lived in urbanized areas. People in the labour market (aged 20-49 years) were affected more often than others. HAT affected men and women equally. It also affected at higher rates people who moved around a lot and those who worked in rural or domestic activities, especially those in close contact with watercourses. Sleep disorders were the primary clinical sign (85%). Cervical adenopathies were observed frequently (66%). Fever was reported in 68% of case-patients. Most (73.5%) were diagnosed at a very advanced stage of infection (meningoencephalitic or neurological stage). CONCLUSION: These results highlight several modifiable or avoidable characteristics associated with HAT. Interventions on them might make it possible to reduce the morbidity and mortality rates associated with HAT and prevent wider extension of this disease.

[Antibiotics dispensed upon the recommendation of staff in private dispensaries in Abidjan in the Ivory Coast]. / Antibiotiques delivres sur conseil par le personnel des pharmacies privees de la ville d'Abidjan en Cote d'Ivoire.

BACKGROUND: The inappropriate dispensing of antibiotics and inadequate antibiotic treatment leads to the emergence of bacterial resistance. The aim of this study is to assess and describe the antibiotics dispensed upon the recommendation of staff in private pharmacies in Abidjan. It is also a matter of determining whether the information given when the drug is dispensed encourages the correct compliance of the antibiotic treatment by the patients. METHODS: Eighteen private pharmacies were in these private pharmacies was recorded using observation handbooks. Focus groups were set up with staff from the private pharmacies with the aim of better understanding of the actions observed. In the study, only antibiotics administered in systemic way were taken into account. RESULTS: One thousand one hundred and twenty-three purchases of antibiotics were observed in total, 158 of which were dispensed upon the recommendation of staff in the private pharmacies (14.1%) [95% CI = 12.1-16.3%]. Penicillin, co-trimoxazole and macrolides constituted the most frequently recommended groups of antibiotics. Compared with the assistants, the pharmacists recommended antibiotics more frequently to customers. The three main groups of symptoms leading to the dispensing of antibiotics upon recommendation were respiratory, gastro-intestinal and cutaneous symptoms. The staff in private pharmacies almost systematically recommended antibiotics for loose coughs lasting more than three days without taking into account the customer's age, general condition and extra-respiratory signs. The duration of the antibiotic treatment was clearly given in 25 cases (15.8%) and information telling customers to take antibiotics at mealtimes was only given on exceptional occasions. It transpired from the meetings conducted with pharmacy staff that there were indirect financial incentives, known as "Unités Gratuites", offered by the medical reps from certain pharmaceutical laboratories, encouraging the excessive dispensing of antibiotics. CONCLUSION: The staff in private pharmacies in Abidjan advise customers to take antibiotics even though they are prescription-only drugs. This leads to the inappropriate dispensing of antibiotics. Some information essential for the correct compliance of the treatment by patients, such as the duration of the treatment and taking it at mealtimes, are often omitted. Educational interventions aimed at pharmacy staff and measures encouraging the application of the law on the sale of antibiotics, are necessary to improve the dispensing of these drugs in private pharmacies in Abidjan.

[Knowledge and perceptions of staff working in private dispensaries in Abidjan as regards bacterial resistance]. / Connaissances et perceptions du personnel des pharmacies privées de la ville d'Abidjan vis-à-vis de la résistance bactérienne.

UNLABELLED: Private dispensaries play an important role in the use of drugs such as antibiotics at community level. However, the knowledge and perceptions of staff working in these private dispensaries as regards bacterial resistance have not been sufficiently studied. OBJECTIVES: To assess the knowledge and perceptions of staff working in private dispensaries in Abidjan as regards bacterial resistance. MATERIALS AND METHODS: A survey was carried out among 123 members of staff working in private dispensaries, during a horizontal study conducted in 18 private dispensaries selected at random in the town of Abidjan in the Ivory Coast. Group meetings were also held to better understand the perceptions of staff working in these private dispensaries as regards bacterial resistance. RESULTS: Four antibiotics out of five bought in these private dispensaries in Abidjan were dispensed by pharmacy assistants. However, they were less informed than the pharmacists as regards bacterial resistance and the factors involved in its emergence. All the pharmacists interviewed in the study showed a good theoretical knowledge of bacterial resistance. However, the group meetings revealed that the risks of emergence of bacterial resistance in the case of antibiotics being dispensed without a prescription, and the threat of this resistance in terms of public health, were less perceived by the pharmacists. CONCLUSIONS: Assistants in dispensaries are less well-informed about bacterial resistance and the factors determining its emergence even though they dispense the most antibiotics to customers. Pharmacists have theoretical knowledge of bacterial resistance but are less conscious of its impact in terms of public health. Information campaigns on bacterial resistance are highly recommended as regards staff working in private dispensaries in Abidjan.

Disseminated Rhizopus microsporus infection in a patient on oral corticosteroid treatment: a case report.

A 71-year-old male with mild steroid-induced hyperglycaemia was diagnosed with a lethal invasive Rhizopus microsporus infection. Disseminated zygomycosis is a rare entity and is most frequently found in neutropenic patients with haematological malignancies, post-transplants or in patients on deferoxamine therapy. Infection is characterised by tissue infarction and necrosis due to angioinvasive hyphae. Culture of Zygomycetes is necessary for species determination but histology is a must to prove the infection. Ante-mortem diagnosis and culture is challenging and therefore mortality approaches 100%. Apart from amphotericine B, most anti-fungals have no activity against Zygomycetes but posaconazole might offer new possibilities as a first-line agent. Timely diagnosis, rapid surgery of infected tissue, correction of underlying disorders and correct anti-fungal therapy might be life-saving. Due to the increasing use of potent immunosuppression, stem cell and organ transplants and possibly selection for Zygomycetes by prior treatment with broad-spectrum antifungal therapy, the incidence of zygomycosis is rising. Therefore, clinicians might encounter an increasing number of zygomycosis cases in the near future.

Comparison of the value of measurement of serum galactomannan and Aspergillus-specific antibodies in the diagnosis of canine sino-nasal aspergillosis.

Serology is currently used for the diagnosis of canine sino-nasal aspergillosis (SNA). However, the accuracy of serological testing using commercially available, standardized purified antigen preparations of Aspergillus (CAPurAspAg) has only been poorly documented. The aim of the present study was to assess the diagnostic value of an agar-gel double immunodiffusion (AGDD) test and an anti-Aspergillus IgG ELISA, using CAPurAspAg and the commercially available Platelia test for the detection of serum galactomannan. Sera from 17 dogs with SNA, 18 dogs with a nasal tumour (NT), 11 dogs with lymphoplasmacytic rhinitis (LPR) and 33 control dogs were tested with the 3 methods. AGDD result was positive in 76.5% of dogs with SNA, whereas all sera from dogs with non-fungal nasal disease and control dogs were negative. A positive IgG ELISA result was obtained in 88% of dogs with SNA and in 18% of dogs with LPR. All patients with NT and control dogs had a negative IgG ELISA result. The Platelia test was positive in 24% of dogs with SNA, 11% of dogs with NT, 9% of dogs with LPR and 24% of control dogs. The results of this study suggest that (1) the detection of serum Aspergillus-specific antibodies with AGDD or ELISA, using CAPurAspAg, provides excellent specificity and good sensitivity, (2) the specificity is higher for AGDD (100%) than for ELISA (96.8%) while sensitivity is higher for ELISA (88.2%) than for AGDD (76.5%) and (3) serum galactomannan quantification with the Plateliat test is unreliable for the diagnosis of canine SNA.

Screening of medicinal plants from Reunion Island for antimalarial and cytotoxic activity.

AIM OF THE STUDY: Nine plants from Reunion Island, selected using ethnopharmacology and chemotaxonomy, were investigated for their potential antimalarial value. MATERIALS AND METHODS: Thirty-eight extracts were prepared by maceration using CH(2)Cl(2) and MeOH, and were tested for in vitro activity against the 3D7 and W2 strain of Plasmodium falciparum. The most active extracts were then tested for in vitro cytotoxicity on human WI-38 fibroblasts to determine the selectivity index. Those extracts were also investigated in vivo against Plasmodium berghei infected mice. RESULTS: Most active of the extracts tested were the dichloromethane leaves extracts of Nuxia verticillata Lam. (Buddlejaceae), Psiadia arguta Voigt. (Asteraceae), Lantana camara L. (Verbenaceae), the methanol extracts from Aphloia theiformis (Vahl) Benn. (Aphloiaceae) bark, and Terminalia bentzoe L. (Combretaceae) leaves displaying in vitro IC(50) values ranging from 5.7 to 14.1mug/ml. Extracts from Psiadia, Aphloia at 200mg/(kgday) and Teminalia at 50mg/(kgday) also exhibited significant (p<0.0005) parasite inhibition in mice: 75.5%, 65.6% and 83.5%, respectively. CONCLUSION: Two plants showed interesting antimalarial activity with good selectivity: Aphloia theiformis and Terminalia bentzoe. Nuxia verticillata still needs to be tested in vivo, with a new batch of plant material.

[Hand hygiene: first measure to control nosocomial infection]. / Hygiène des mains: Première mesure pour la maîtrise des infections nosocomiales.

Hand hygiene prevents cross infection in hospi tals, however adherence to guidelines is commonly poor. The hand-hygiene promotion programme started on May 2004 at the University Hospital of Liège after a baseline survey of compliance. We attempted to promote hand hygiene and most par ticularly alcohol-based hand disinfection. We measured MRSA transmission rates and consumption of alcohol-based handrub solution and soap in parallel. During the campaign, consump tion of alcohol-based handrub solution and soap increased by 56% and 24% respectively and MRSA transmission rates decreased from 11,04 to 7,07 cases per 1000 admissions.

[Infectious serology: interpretation of the results and traps to avoid]. / Sérologie infectieuse: interprétation des résultats et pièges a eviter.

In Medical Microbiology, in addition to the direct methods of indentification of infectious agentss, the serologic indirect techniques by quantification of antibodies have extremely useful in infectiology, for the diagnosis and the therapeutic or vaccination follow-up as well as for epidemiologic enquiries, serodiagnosis methods have significantly improved. Meanwhile, results may reveal hard to interpret, especially when are tries to specify the time of the beginning of an infection. The results require in the majority of the cases to be compared on two subsequent serum samples, to observe a possible increase in antibodies level. In addition, the infectious serology results may not be considered as the only element of final diagnosis. In all cases, they have to be interpreted and challenged against the clinical context.