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A multicentre study was conducted in 27 hospitals in Algeria, Egypt, Italy, Morocco and Tunisia to evaluate the prevalence and characteristics of the nosocomial infections. The study population (4634 patients) was relatively young, mean age 41.1 (standard deviation 23.4) years. The prevalence of nosocomial infections was 10.5%; this was higher in non-teaching centres and moderate-sized hospitals. Overall, urinary tract infections were the most common. Paediatric departments rated particularly high (11.3%). The most commonly isolated organisms were: Escherichia coli (17.2%), Staphylococcus aureus (12.5%), Pseudomonas aeruginosa and Klebsiella pneumoniae (9.2% each). On the day of the study, 40.7% of the patients were under treatment with antibiotics, with nearly half for an empirical indication. Nosocomial infection was significantly associated with mechanical ventilation, hospitalization > or = 8 days, presence of a central or peripheral catheter), urinary catheter, diabetes and age.

Hand hygiene literature is scarce in the southern Mediterranean area. In order to establish a baseline position, a study was performed in four Mediterranean countries. Seventy-seven hospital wards in 22 hospitals were enrolled and information on hand hygiene practice and facilities were collected. The overall compliance rate was very low (27.6%), and was significantly higher where the perceived risk was considered to be high. Intensive care units showed the highest level of compliance. Analysis by country indicated higher compliance in Egypt (52.8%) and Tunisia (32.3%) compared with Algeria (18.6%) and Morocco (16.9%). Facilities for hand hygiene, particularly consumables, were shown to be deficient. Multi-approach programmes combining the production of official local recommendations, education and regular evaluation of hand hygiene practice are much needed to improve the present situation.