Kind Of Infection Research Articles

Assessment of systemic cellular inflammatory response after spontaneous intracerebral hemorrhage

ObjectiveAfter spontaneous intracerebral hemorrhage (ICH) a local and systemic inflammatory response is activated. Interleukin-6 (IL) is one of most relevant orchestrators of inflammatory responses in the brain and is released from multiple immune cells, including neutrophils. Herby we assessed the relevance of systemic inflammation in patients suffering ICH. MethodsFrom October 2010 to October 2011 we included in our routine of laboratory investigations besides to C-reactive protein (CRP), the addition of IL-6 and an analysis of the subpopulation of circulating blood cells. Values at admission, at 3rd and 7th day after admission were evaluated. We analyzed 43 patients with non-traumatic ICH; stroke-related ICH or tumor associated hemorrhage were excluded. Outcome variables were 30 and 90-day mortality and NIHSS at discharge. A natural logarithmic transformation of IL-6, lymphocytes, and monocytes was used. Results8.6% died within 30-days and mortality increased to 39.5% at 90th day. Total leukocytes and neutrophils as well as IL-6 at admission were statistically significant increased among patients who died within 30days after ICH onset (p=0.002). IL-6 and CRP in follow-up (3rd and 7th day) were higher among patients with poor outcome (NIHSS >15). The number of circulating lymphocytes and monocytes was not different in measurement. Leukocytes and neutrophils at 3rd day after admission were augmented in patients with respiratory infection and CRP in follow-up increased if some kind of infection was clinically or microbiologically detected. IL-6 at admission and in follow-up and monocytes at 7th day were related to ICH volume. CRP-values at 3rd or 7th day but not at admission were associated to bigger ICH-volume. The values of IL-6 were highly correlated to 30-day mortality and volume of ICH as CRP only with ICH volume. ConclusionAfter ICH onset a systemic activation of immune system seems to be induced and may be influencing outcome. Peripheral recruitment of leukocytes, especially neutrophils could be a target for future therapeutic interventions. Because of the tighter correlation of IL-6 at admission, it might be more accurate for prognostic issues than CRP.

Предотвращение экологической опасности объектов автотранспортной инфраструктуры

This article deals with the problem of ecological danger of road infrastructure objects. Road infrastructure includes bus stations, bus depots, car service centers and roadside cafes located throughout the highway system. With the implementation of mass-produced counterfeit water and food in the catering outlets and around the purification of them from all kinds of infections is relevant.

An Unusual Case of Echinostomiasis in a Retropositive Patient: A Case Report

This report describes an unusual case of echinostomiasis in a retropositive patient with swelling, pain, and purulent discharge over back and right scapular region for 10 days. Stool examination revealed the presence of eggs of hookworm and echinostome. Diagnosis is challenging due to few characteristic features of eggs of echinostomes. They usually infect birds and mammals, and only limited species are implicated in the causation of human disease. Mild infections are of little significance, but heavy fluke burden may lead to significant abdominal symptoms. Incidence of echinostomiasis is higher in Southeast Asian countries, and this report is an unusual case in India. We discuss general desirability of awareness of this kind of infection and training for better detection.

The frequency of hospital-acquired infections in Mousavi Hospital Zanjan, Iran

Hospital-acquired infections occur in 5 to 10% of admitted patients in hospital. It is one of the main reasons for death of many hospitalized patients especially in developing countries. Therefore, finding ways to control these infections should be a priority and certainly the first step in achieving this goal. The aim of this study was to determine the frequency of hospital-acquired infections and related factors in Mousavi Hospital in Zanjan, Iran. The demographic data and data about the kind of infection, admission, duration and the ward of admission were reviewed. Statistical analysis was performed by SPSS version 16.0. Among 34102 admitted patients from 21st March 2013 to 21st March 2014 in Mousavi hospital in Zanjan, Iran, 206 (0.6%) patients, 141 (68.4%) male and 65 (31.6%) female, met the criteria of hospital-acquired infections. The highest frequency was in the burn ward with 82 (20.55%) patients. The most common type of infections were surgical site infections, pneumonia, urinary tract infection, sepsis and eye infection respectively. There was a significant correlation between the type of hospital-acquired infections and hospital wards (P=0.0001). The rate of hospital-acquired infections in this study is lower than other studies, which can be due to an effective way of infection control with continuous surveillance and health education for hospital staffs. However, poor diagnostic methods and failure in the reporting system of infections should be considered.

The frequency of hospital-acquired infections in Mousavi Hospital Zanjan, Iran

Hospital-acquired infections occur in 5 to 10% of admitted patients in hospital. It is one of the main reasons for death of many hospitalized patients especially in developing countries. Therefore, finding ways to control these infections should be a priority and certainly the first step in achieving this goal. The aim of this study was to determine the frequency of hospital-acquired infections and related factors in Mousavi Hospital in Zanjan, Iran. The demographic data and data about the kind of infection, admission, duration and the ward of admission were reviewed. Statistical analysis was performed by SPSS version 16.0. Among 34102 admitted patients from 21st March 2013 to 21st March 2014 in Mousavi hospital in Zanjan, Iran, 206 (0.6%) patients, 141 (68.4%) male and 65 (31.6%) female, met the criteria of hospital-acquired infections. The highest frequency was in the burn ward with 82 (20.55%) patients. The most common type of infections were surgical site infections, pneumonia, urinary tract infection, sepsis and eye infection respectively. There was a significant correlation between the type of hospital-acquired infections and hospital wards (P=0.0001). The rate of hospital-acquired infections in this study is lower than other studies, which can be due to an effective way of infection control with continuous surveillance and health education for hospital staffs. However, poor diagnostic methods and failure in the reporting system of infections should be considered.

Stężenie rezystyny w surowicy noworodków donoszonych, z zakażeniami wewnątrzmacicznymi

ObjectiveResistin plays an important role in the development of the fetus and newborn, but the effect of intrautherine infections on resistin value is not well known. AimThe evaluation of serum resistin concentrations in healthy and infected full-term newborns according to their gender, type of delivery, birth asphyxia and kind of infection and determination of correlations between resistin concentrations and birth weight and length, fetal maturity and head and chest circumferences. Material and methodsThe study involved 114 (66 boys, 48 girls) newborns, among them 54 with intrautherine infections and 60 healthy (control). Sepsis was diagnosed in 13 cases and other local infections in 41 newborns. Serum resistin concentrations were measured between 3rd and 7th day of life by ELISA method. ResultsIt was found that mean serum resistin concentration was significantly lower in infected newborns (median 17.8 ng/ml), especially with local infections (17.3), than in healthy (27.1). Neonatal gender and type of delivery had no influence on mean serum resistin values in both group. No significant correlations between resistin concentrations and birth weight and length, fetal maturity and head and chest circumferences, both in infected and healthy newborns, were stated. Conclusions1) Intrautherine infections in full-term newborns contribute to decrease of resistin concentration, independently of their gender, general condition of newborns after birth and type of delivery. 2) In healthy and infected newborns any significant correlations between serum resistin concentrations and birth weight, body length, head and chest circumferences were noted.

The Klebsiella pneumoniae YfgL (BamB) lipoprotein contributes to outer membrane protein biogenesis, type-1 fimbriae expression, anti-phagocytosis, and in vivo virulence

ABSTRACTKlebsiella pneumoniae is an opportunistic pathogen that causes several kinds of infections, including pneumonia, bacteremia, urinary tract infection and community-acquired pyogenic liver abscess (PLA). Adhesion is the critical first step in the infection process. Our previous work demonstrated that the transcellular translocation is exploited by K. pneumoniae strains to migrate from the gut flora into other tissues, resulting in systemic infections. However, the initial stages of K. pneumoniae infection remain unclear. In this study, we demonstrated that a K. pneumoniae strain deleted for yfgL (bamB) exhibited reduced adherence to and invasion of host cells; changed biogenesis of major β-barrel outer membrane proteins; decreased transcriptional expression of type-1 fimbriae; and increased susceptibility to vancomycin and erythromycin. The yfgL deletion mutant also had reduced ability to against neutrophil phagocytosis; exhibited decreased induction of host IL-6 production; and was profoundly attenuated for virulence in a K. pneumoniae model of bacteremia. Thus, the K. pneumoniae YfgL lipoprotein mediates in outer membrane proteins biogenesis and is crucial for anti-phagocytosis and survival in vivo. These data provide a new insight for K. pneumoniae attachment and such knowledge could facilitate preventive therapies or alternative therapies against K. pneumoniae.

Cancer Risk in Patients With Empyema: A Nationwide Population-Based Study.

This study aimed to evaluate cancer risk and possible risk factors in patients diagnosed with empyema. A total of 31,636 patients with newly diagnosed empyema between January 1, 1999 and December 31, 2010 were included in this study. Standardized incidence ratios (SIRs) were calculated to compare the cancer incidence in these empyema patients to that in the general population. Adjusted hazard ratios were also calculated to investigate whether characteristics increased cancer risk. During the 12-year study period, 2,654 cancers occurred in 31,636 patients with empyema, yielding an SIR of 2.67 (95% confidence interval [CI] 2.57-2.78). We excluded cancer that occurred within 1 year to avoid surveillance bias. The cancer risk remained significantly increased (SIR 1.50, 95% CI 1.41-1.58). Specifically, patients with empyema had higher SIR of cancers of the head and neck (1.50, 95% CI 1.41-1.58), esophagus (2.56, 95% CI 1.92-3.33), stomach (1.49, 95% CI 1.16-1.89), liver and biliary tract (2.18, 95% CI 1.93-2.45), and lung and mediastinum (1.62, 95% CI 1.39-1.86). Age ≥ 60, male sex, diabetes mellitus, and liver cirrhosis were independent risk factors for cancer development. Our study demonstrates an increased incidence of cancer development in patients with empyema, and patients' age ≥ 60, men, and those with diabetes mellitus and liver cirrhosis showed a higher incidence of developing cancer compared to the general population. The association between such kind of infection and secondary malignancy may be elucidated by further study.

Trends in the Prevalence of Helicobacter Pylori Infection in Fardis, Iran, 2011 - 2014

Background: One of the most common causes of chronic bacterial infections is H. pylori and there is evidence indicative of its strong association with gastric cancer. Objectives: We aimed to determine the prevalence of H. pylori infection using Gram staining, IgG, urea breath test (UBT), and stool antigen from patients with gastrointestinal (GI) symptoms. Materials and Methods: Patients with GI symptoms who were referred to Fardis Central Laboratory, Fardis, Iran for identification of H. pylori from different clinical specimens from 2011 to 2014 were included in this study. Demographic data were retrieved from the medical records of enrolled patients. Results: A total of 16002 patients were referred to Fardis Central Laboratory, Fardis, Iran over the past 3 years. Among them, 5662 (35.38%) were males and 10340 (64.62%) females; their mean age was 48 years (range 3 to 93 years). Of 16002 patients tested, 6770 (83.77%), 137 (1.69%), and 1174 (14.54%) were positive for H. pylori according to the results of immunoglobulin G (IgG), urea breath test (UBT), and H antigen, respectively. Conclusions: H. pylori infection rate in patients referring to Fardis Lab with GI symptoms was relatively high which could be due to some health habits. Although this kind of infection is considerably common, it can easily be diagnosed by noninvasive tests.

Epidemiology of Staphylococcus aureus Nasal Carriage Patterns in the Community.

Staphylococcus aureus (S. aureus) is a Gram-positive opportunistic pathogen that colonizes frequently and asymptomatically the anterior nares of humans and animals. It can cause different kinds of infections and is considered to be an important nosocomial pathogen. Nasal carriage of S. aureus can be permanent or intermittent and may build the reservoir for autogenous infections and cross-transmission to other individuals. Most of the studies on the epidemiology of S. aureus performed in the past were focused on the emergence and dissemination of methicillin-resistant Staphylococcus aureus (MRSA) in healthcare settings. There are, however, a number of more recent epidemiological studies have aimed at analysing carriage patterns over time in the community settings providing new insights on risk factors for colonization and important data for the development of strategies to prevent infections. This chapter aims to give a review of current epidemiological studies on S. aureus carriage patterns in the general community and put them into perspective with recent, yet unpublished, investigations on the S. aureus epidemiology in the general population in northern Germany.

Nosocomial infection and its molecular mechanisms of antibiotic resistance.

Nosocomial infection is a kind of infection, which is spread in various hospital environments, and leads to many serious diseases (e.g. pneumonia, urinary tract infection, gastroenteritis, and puerperal fever), and causes higher mortality than community-acquired infection. Bacteria are predominant among all the nosocomial infection-associated pathogens, thus a large number of antibiotics, such as aminoglycosides, penicillins, cephalosporins, and carbapenems, are adopted in clinical treatment. However, in recent years antibiotic resistance quickly spreads worldwide and causes a critical threat to public health. The predominant bacteria include Methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, and Acinetobacter baumannii. In these bacteria, resistance emerged from antibiotic resistant genes and many of those can be exchanged between bacteria. With technical advances, molecular mechanisms of resistance have been gradually unveiled. In this review, recent advances in knowledge about mechanisms by which (i) bacteria hydrolyze antibiotics (e.g. extended spectrum β-lactamases, (ii) AmpC β-lactamases, carbapenemases), (iii) avoid antibiotic targeting (e.g. mutated vanA and mecA genes), (iv) prevent antibiotic permeation (e.g. porin deficiency), or (v) excrete intracellular antibiotics (e.g. active efflux pump) are summarized.

History of Antibiotics Research.

For thousands of years people were delivered helplessly to various kinds of infections, which often reached epidemic proportions and have cost the lives of millions of people. This is precisely the age since mankind has been thinking of infectious diseases and the question of their causes. However, due to a lack of knowledge, the search for strategies to fight, heal, and prevent the spread of communicable diseases was unsuccessful for a long time. It was not until the discovery of the healing effects of (antibiotic producing) molds, the first microscopic observations of microorganisms in the seventeenth century, the refutation of the abiogenesis theory, and the dissolution of the question "What is the nature of infectious diseases?" that the first milestones within the history of antibiotics research were set. Then new discoveries accelerated rapidly: Bacteria could be isolated and cultured and were identified as possible agents of diseases as well as producers of bioactive metabolites. At the same time the first synthetic antibiotics were developed and shortly thereafter, thousands of synthetic substances as well as millions of soil borne bacteria and fungi were screened for bioactivity within numerous microbial laboratories of pharmaceutical companies. New antibiotic classes with different targets were discovered as on assembly line production. With the beginning of the twentieth century, many of the diseases which reached epidemic proportions at the time-e.g., cholera, syphilis, plague, tuberculosis, or typhoid fever, just to name a few, could be combatted with new discovered antibiotics. It should be considered that hundred years ago the market launch of new antibiotics was significantly faster and less complicated than today (where it takes 10-12years in average between the discovery of a new antibiotic until the launch). After the first euphoria it was quickly realized that bacteria are able to develop, acquire, and spread numerous resistance mechanisms. Whenever a new antibiotic reached the market it did not take long until scientists observed the first resistant germs. Since the marketing of the first antibiotic there is a neck-on-neck race between scientists who discover natural or develop semisynthetic and synthetic bioactive molecules and bacteria, which have developed resistance mechanisms. The emphasis of this chapter is to give an overview of the history of antibiotics research. The situation within the pre-antibiotic era as well as in the early antibiotic era will be described until the Golden Age of Antibiotics will conclude this time travel. The most important antibiotic classes, information about their discovery, activity spectrum, mode of action, resistance mechanisms, and current application will be presented.

Cercarial Dermatitis or Cercariosis: What's in a Name?

'Cercarial dermatitis' is the common scientific name used to describe the allergic response to attacks in humans from nonspecific skin-penetrating cercariae. However, this term may be too narrowly focused and misleading due to numerous factors. The substitution of the broader term 'cercariosis' is suggested for these kinds of infections.

Serum uric acid levels in patients with infections of central nervous system.

The lower levels of serum uric acid (UA) correlated with meningitis have been reported. However, comparison of UA levels among different kinds of infections of central nervous system (CNS) and changes of UA levels before and after treatment are unknown. Our study aimed to investigate the antioxidant status of serum UA in five common types of CNS infections. We retrospectively evaluated serum UA levels of 399 patients with different types of CNS infections including viral meningitis or meningoencephalitis (VM), brain cysticercosis (BC), tuberculous meningitis or meningoencephalitis (TM), cryptococcus meningitis or meningoencephalitis (CM) and bacterial meningitis or meningoencephalitis (BM), and 119 healthy controls. The changes of serum UA were examined and analyzed. The serum levels of UA in patients with CNS infections were significantly lower than those in normal subjects and among in TM, CM and BM groups were apparently lower when compared with VM and BC groups; otherwise, after effective therapy, serum UA levels were obviously higher than before. Our findings showed that patients with CNS infections had lower serum UA levels, which was independent of the classification and the serum UA levels increased obviously after valid treatment, the variation of UA levels might be considered as an indicator of clinical curative effect in patients with CNS infections.

Livestock-Associated MRSA: The Impact on Humans.

During the past 25 years an increase in the prevalence of methicillin-resistant Staphylococcus aureus (HA-MRSA) was recorded worldwide. Additionally, MRSA infections may occur outside and independent of hospitals, caused by community associated MRSA (CA-MRSA). In Germany, we found that at least 10% of these sporadic infections are due to livestock-associated MRSA (LA-MRSA), which is initially associated with livestock. The majority of these MRSA cases are attributed to clonal complex CC398. LA-MRSA CC398 colonizes the animals asymptomatically in about half of conventional pig farms. For about 77%–86% of humans with occupational exposure to pigs, nasal carriage has been reported; it can be lost when exposure is interrupted. Among family members living at the same farms, only 4%–5% are colonized. Spread beyond this group of people is less frequent. The prevalence of LA-MRSA in livestock seems to be influenced by farm size, farming systems, usage of disinfectants, and in-feed zinc. LA-MRSA CC398 is able to cause the same kind of infections in humans as S. aureus and MRSA in general. It can be introduced to hospitals and cause nosocomial infections such as postoperative surgical site infections, ventilator associated pneumonia, septicemia, and infections after joint replacement. For this reason, screening for MRSA colonization at hospital admittance is recommended for farmers and veterinarians with livestock contacts. Intrahospital dissemination, typical for HA-MRSA in the absence of sufficient hygiene, has only rarely been observed for LA-MRSA to date. The proportion of LA-MRSA among all MRSA from nosocomial infections is about 3% across Germany. In geographical areas with a comparatively high density of conventional farms, LA-MRSA accounts for up to 10% of MRSA from septicemia and 15% of MRSA from wound infections. As known from comparative genome analysis, LA-MRSA has evolved from human-adapted methicillin-susceptible S. aureus, and the jump to livestock was obviously associated with several genetic changes. Reversion of the genetic changes and readaptation to humans bears a potential health risk and requires tight surveillance. Although most LA-MRSA (>80%) is resistant to several antibiotics, there are still sufficient treatment options.

Mutations in Breast Cancer Exome Sequences Predict Susceptibility to Infections and Converge on the Same Signaling Pathways

Many mutations in breast cancer exome sequences alter susceptibility to infections. An exhaustive analysis of all the mutations in exomes from 103 breast cancer cases found that more than 1,000 genes have a published association with some kind of infection, including all known tumor viruses. Altered susceptibility to infection was identified as a common thread connecting breast cancer mutations in genes traditionally classified as coding for diverse functions, including cell immunity, cell architectural barriers, stromal interactions, cell adhesion, DNA damage responses, translation, cell cycle control, metabolism, homeostasis, transport, and neurosensing. Infections and mutations can both contribute to cancer because they deregulate the same pathways. In many cases, infections make a contribution to cancer that is either known or biologically plausible. Interventions may be possible to prevent occult infections from cooperating with mutations to cause further cancer, metastasis, or other complications. The emerging list of infection–gene mutation associations is readily scalable to routine testing of large human data sets.

Infection as a Trigger for Portal Hypertension

Background: Microbial infections are a relevant problem for patients with liver cirrhosis. Different types of bacteria are responsible for different kinds of infections: Escherichia coli and Klebsiella pneumoniae are frequently observed in spontaneous bacterial peritonitis or urinary tract infections, and Streptococcus pneumoniae and Mycoplasma pneumoniae in pulmonary infections. Mortality is up to 4-fold higher in infected patients with liver cirrhosis than in patients without infections. Key Messages: Infections in patients with liver cirrhosis are due to three major reasons: bacterial translocation, immune deficiency and an increased incidence of systemic infections. Nonparenchymal liver cells like Kupffer cells, sinusoidal endothelial cells and hepatic stellate cells are the first liver cells to come into contact with microbial products when systemic infection or bacterial translocation occurs. Kupffer cell (KC) activation by Toll-like receptor (TLR) agonists and endothelial sinusoidal dysfunction have been shown to be important mechanisms increasing portal pressure following intraperitoneal lipopolysaccharide pretreatment in cirrhotic rat livers. Reduced intrahepatic vasodilation and increased intrahepatic vasoconstriction are the relevant pathophysiological pathways. Thromboxane A₂ and leukotriene (LT) C₄/D₄ have been identified as important vasoconstrictors. Accordingly, treatment with montelukast to inhibit the cysteinyl-LT₁ receptor reduced portal pressure in cirrhotic rat livers. Clinical studies have demonstrated that activation of KCs, estimated by the amount of soluble CD163 in the blood, correlates with the risk for variceal bleeding. Additionally, intestinal decontamination with rifaximin in patients with alcohol-associated liver cirrhosis reduced the portal pressure and the risk for variceal bleeding. Conclusions: TLR activation of nonparenchymal liver cells by pathogens results in portal hypertension. This might explain the pathophysiologic correlation between microbial infections and portal hypertension in patients with liver cirrhosis. These findings are the basis for both better risk stratifying and new treatment options, such as specific inhibition of TLR for patients with liver cirrhosis and portal hypertension.

Hepatitis B virus infection and gastric cancer risk: pitfalls in the potential association

Sir, We read with great interests the retrospective case–control study by Wei et al (2015). As the authors Wei et al introduced that epidemiological study is the first one, which found a potential association between hepatitis B virus (HBV) serology and gastric cancer risk. This main finding is indeed surprising to readers. On the basis of the literature from Chinese CNKI journal database, the prevalence of HBV DNA in gastric cancer tissues is only 0–3% by PCR test. Therefore, to evidence the causality between HBV infection and gastric cancer risk, a qualified study with adequate statistical power requires a dramatically larger scale of sample size than that of the study by Wei et al (2015). In particular, direct detection of HBV DNA in gastric cancer cells by in situ hybridisation is the most convincing evidence to confirm that association. As known, WHO has defined Helicobacter pylori as a class I human carcinogen for gastric cancer development (Fock et al, 2013). Besides, Epstein–Barr virus infection is also found to be associated with around 10% of gastric cancer (Murphy et al, 2009). However, in the study by Wei et al (2015), these two critical confounders were not considered in the logistic regression models. The investigated population in the study by Wei et al (2015) is also collected from an endemic region (Guangzhou Province) of both Helicobacter pylori and Epstein–Barr virus infections in mainland China (Wang and Chen, 2014). Therefore, the results are unable to rule out the confounding effects from these two kinds of infections. Probably, the association between HBV infection and gastric cancer risk might be biased by chance, imbalance of prevalence of H. pylori and/or Epstein–Barr virus infection in stomach, or potentially indirect linkage between HBV and those two pathogens. Without the adjustment for those two co-infections, the results may have a risk of misleading readers. Thus, we would like to underline these pitfalls behind interpreting the results to readers and practitioners. Critically, the epidemiological study Wei et al provides some information about the potential association between HBV infection and gastric cancer risk, but the obvious defect in covariate modelling makes the results still far from public health policy and clinical practice. Despite of that, the interesting findings also suggest further investigations with large scale and well-adjusted model to rule out potential biases.

Adherence to Hand Hygiene in Health Care Workers in a Tertiary Care Hospital

Background and Objective: Hand hygiene is an important practice to prevent various kinds of infections. It is of utmost importance in health care workers to prevent Nosocomial infections. Various health care individuals like doctors, nurses and other paramedical staff are responsible for the spread of Nosocomial infections. In order to prevent this hand hygiene should be practiced at all levels. Observation of hand hygiene compliance of health care workers helps in assessing their knowledge and also provides ground for further improvements in hand hygiene. By improving their hand hygiene compliance Nosocomial infections can be prevented which is growing at an alarming rate throughout the world. Methodology: This is a cross sectional study conducted at Apollo General Hospital, Hyderabad. Heath care workers such as doctors, nurses and other paramedical staff of various departments were observed for hand hygiene compliance. For assessing their knowledge, and perception about hand hygiene a survey was conducted by giving a questionnaire. Results: 100 health care workers from ward 6, ward 4, gynaecology, paediatrics, ICU and surgery departments were considered for the study. Paediatrics department had the highest compliance rate of 56% and surgery had the lowest compliance rate of 31%. WHO hand washing moment 3 had the highest compliance of 83.3% while before touching the patient (moment 1) had the lowest compliance of 12%. Conclusion: The overall compliance rate observed is at average of 41.1%. Health care associated infections can be prevented by effective hand hygiene practices. This research provides a framework to measure the hand hygiene compliance of medical and paramedical staff working in Health care setting. Direct observation remains a widely used, easily reproducible method for monitoring compliance. Key words: Hand hygiene, Nosocomial infection, WHO

Haemophilus influenzae: a forgotten cause of neonatal sepsis?

Due to the introduction of the conjugate vaccine against serotype b, neonatal sepsis caused by Haemophilus influenzae became very rare. There is little data in Belgium concerning the prevalence of H. influenzae early onset neonatal sepsis and articles about neonatal sepsis and H. influenzae published in the last decade are scarce. We report two invasive infections with a non-typeable H. influenzae. These cases show that neonatal sepsis caused by non-typeable H. influenzae may be underestimated and we believe that there is need for a better registration of this kind of infection.