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Two mobile units for air filtration with recycling designed to reduce the aerobiocontamination of hospital rooms were tested. Their efficacity was evaluated by measurement of particle retention and by quantitative determination of the reduction of aerobiocontamination in rooms occupied by patients. Results show a significant improvement in the aerobiocontamination of test rooms as compared to control rooms. It is thus reasonable to suppose that these systems may provide a practical solution to the problems posed by hospitalization in ordinary rooms of patients subjected to aplasive chemotherapy. A randomized clinical trial is in progress.

After classifying the nosocomial urinary tract infections, between the hospital acquired infections, this paper review different prevention means proposed to limit their incidence. These consist essentially of recommendations concerning the vesical catheterism. Thus are reviewed catheter indications, the choice of the catheter, its putting conditions, the creation and conservation of a closed system. Besides, patient informations and bacteriological survey of the catheterized patients are also discussed.

Hospital or nosocomial infection, or infection acquired in hospitals, is a health problem in all hospital departments and particularly in the maternity department. We report on a prospective survey of surveillance of hospital-acquired infections both from the mother and the baby's point of view after delivery vaginally or with caesarean carried out at the obstetrical clinic of the Edouard Herriot Hospital in Lyon (France) over three successive years with a series of 9,204 deliveries. The incidence of infection in women who were delivered without caesarean section was 1.37% when urinary tract infections had been excluded but 13% in women who had caesarean sections. Endometritis, skin infections and urinary tract infections were the leading causes. As far as the newborn were concerned, hospital infection ran at about 2.60% and this in the main was due to staphylococcal pustules in the skin. These figures are still too high and prevention should be based on more information given and more care taken by the whole staff of such a hospital.

Some recommendations for the prevention of nosocomial urinary tract infections are irrefutable, thoroughly admitted. They concern before all the aseptic conditions of setting and care of catheter, to avoid the bacterial penetration in the closed system. They concern the merits of catheter indications, the diminution of catheter conservation period, the applying of a strict asepsis during setting and manipulation of the catheter, the use of a sterile and closed drainage system with a continuous flow. Several improvements concerning the catheter and the drainage system have been proposed. Some of these recommendations have been proved serious and can be applied. On the contrary, the efficiency of others remain to be proved by control assays. Finally, measures with uncertain or unproved values should not be considered.

Hospital costs for 61 neonates with acquired nosocomial infection were compared with 61 matched, uninfected controls. The increase in length of hospital stay (+23 per cent) added to the number of laboratory tests increase total hospitalization costs to 32 per cent. An additional US $1250 for each case of infection is the cost to the Social Security system. The importance of this increase, contrasted with the generally benign nature of the infections studied, justifies the maintenance of high standards of quality in neonatal care.

A retrospective epidemiological study of 22 observations of invasive pulmonary aspergillosis, of which 18 were fatal, occurring over a period of 30 months, implicated certain building sites within the hospital. The building works were responsible for the diffusion into the atmosphere of fungal spores from normally closed reservoirs, notably false ceilings, fibrous thermal and/or acoustic insulation materials and roller-blind casings. The results of our study permit us to suggest that protective measures should be set up or that immunodepressed patients are evacuated when such works are to be carried out in an in-patient establishment.

An epidemiological survey was carried out which included a dual epidemic of septicaemia and pseudo-bacteremia caused by Serratia marcescens. The survey enabled 15 septicaemias and 43 pseudobacteremias to be detected in a regional hospital between March and August, 1983. Two mishandlings were at the origin of the outbreak: citrated tube normally reserved for coagulation tests were severely contaminated by Serratia marcescens, and inaccurate samplings had been made. Once the mechanisms of contamination were found, specific preventive measures put an end to the epidemic. The authors insist on the need for uncontaminated tubes and citrate solutions and for the development of precise sampling methods which are essential to avoid the occurrence of pseudo-bacteremia or septicaemia. It is important to detect such epidemics at an early stage by an efficient control of nosocomial infections, thus avoiding their extension.