The importance of hands in the transmission of nosocomial infection has been world wide admitted. However, it is difficult to induce this behavior in health-care workers. The aim of the present work was to point out the importance of hand bacteria colonization, the influence of hand washing and of patient physical examination. One hundred health-care workers were randomly divided in two groups: Group A without hand washing previous to patient physical examination or handling (PPE); group B with hand washing previous to PPE. Direct fingerprint samples in Columbia agar before and after PPE were obtained. The colonies were counted and identified by conventional techniques, and antibiograms according to NCCLS were performed. Before PPE group A participants showed a high number of bacteria regarding group B participants (73.9 Vs 20.7; p < 0.001); 44 out of 50 participants were carriers of potentially pathogen bacteria. No group B participants were carriers of potential pathogen bacteria before PPE. The latter group showed an increase in number of bacteria after PPE (20.7 CFU (before) Vs 115.9 CFU (after); p < 0.001). Sixteen group B participants were contaminated after PPE with potential pathogens such as S. aureus (50% of them methicillin resistant); Escherichia coli, Pseudomonas aeruginosa and Enterococcus faecalis, half of them multiresistant. We can conclude on the importance of these results to implement educational programs and to provide the health-care workers with the proper commodities to fulfill this practice.

A research investigation to evaluate the potential of an oral preparation of Mycobacterium vaccae SRL172 (NCTC 11659) as an immunotherapeutic has been carried out in ten patients with moderate to advanced pulmonary tuberculosis at Carrasco Hospital, Argentina. Comparison was made between oral and injected M.vaccae sharing a mutual control group. Clinical, bacteriological, hematological, radiological and immunological assessments all showed comparable benefits for both injected and oral treatment over those achieved with chemotherapy alone. The only significant difference between results of injected and oral M.vaccae was the failure of the latter to reduce TNF-alpha production by cultured mononuclear cells. A more intensive regime for the oral preparation was used, which as an addition to the directly observed therapy, short-course, treatment should improve results in both drug susceptible and drug-resistant cases. A Phase II Good Clinical Practice trial is now required.

We report the most frequent species and serovars of enteropathogenic organisms in Rosario from 1985 to 1993. Enteropathogenic Escherichia coli was the most prevalent agent affecting 144/570 (25.2%) children; 0111 represented 41.8%, 055: 13.6%, 0119: 12.7%. Among enterotoxigenic E. coli (ETEC) the most frequent were ETEC-ST 0128:H21 and 0153:H45. Shigella spp were isolated in 8.8%; S.flexneri: 7%, principally type 2 (59.5%); S. sonnei: 1.6%, and S. dysenteriae type 2: 0.2%. Campylobacter spp were found in 6.1% of patients; C.jejuni: 4.6%; C. coli: 1.4% and C. lari: 0.2%; except groups 0 13,50 and 0 4 (2 cases each), no predominant serogroups were found. Salmonella was isolated in 2.8% of cases, being the predominant serovar S. typhimurium until 1986, but a dramatically increase of cases due to S. enteritidis was observed since 1987. There was 1.9% of Aeromonas spp and 2 cases due to Vibrio cholerae non 0-1. No Yersinia was found. In patients with gastroenteritis due to Shigella, Campylobacter, Salmonella, or EPEC as the unique pathogen, leukocytes were observed in the faeces in 70%, 50%, 20%, and 10% of cases respectively.

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We studied the occurrence of reovirus infection in children hospitalized with acute gastroenteritis in Argentina during a 20-year interval (1981 through 2001). Three of 2854 (0.10%) stools were positive for reovirus but negative for adenovirus, astrovirus and rotavirus. Children infected with reovirus were <1 year old; one had meningoencephalitis in addition to gastroenteritis. This study indicates that reovirus is an uncommon cause of childhood gastroenteritis requires medical assistance.

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High relationship between ciprofloxacin use and prevalence of ESBL Klebsiella pneumoniaeBackground: To assess the relationship between ciprofloxacin use and the prevalence of extended spectrum betalactamases (ESBL) Klebsiella pneumoniae. Patients and Methods: Semestral mean values regarding use of antibiotic and prevalence of ESBL Kp were compared during 9 semesters using linear regression and coefficient of correlation. Results: The only statistically significant correlation was ciprofloxacin use and ESBL(+) K. pneumoniae prevalence, with a coefficient of correlation of 0.86 and p = 0.0027 using linear regression. Conclusions: Ciprofloxacin use must be taking into account when considering infection control programs due to high prevalence rates of ESBL(+) K. pneumoniae in the hospital setting.

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