Healthcare-associated infection (HCAI) in hospitals mainly results from unsolved but well-identified causes such as hand hygiene, overuse of catheters, and to a lesser extent, the airborne transmission of infectious agents caused by the misuse of respiratory precautions. The aims of the Institut Hospitalo-Universitaire Méditerranée Infection are to develop new approaches to fight HCAIs. Among them, new technologies that allow for the traceability of care and good practices reminders have been developed concomitantly to an anthropological approach, facilitating acceptability by healthcare workers. While the automated continuous monitoring system is validated and commercially available, some other technologies are still under clinical evaluation or in the early development phase. Quorum sensing-based biotechnologies are developed with the aims to fight against wound colonization.

Objective : The aim of this study is to evaluate the hand hygiene and isolation precaution adhesion of the healthcare workers in routine cares. Methods :In an infectious diseases care unit of a university hospital in Marseille, France, we designed an observational study at evaluating the hand hygiene and isolation precaution adhesion of the healthcare workers in routine cares by remote video recording. The care team including nurses, assistant nurses, housekeepers and physicians was monitored from November 30 th (2012) to February 13 th (2013). From a video camera was placed inside patient room, healthcare workers paths were recorded from entrance to exit of the patient's room. Hand hygiene disinfection as well as gloves and mask wearing in isolation precautions were observed. A video camera was placed inside patient room. Healthcare workers paths were recorded from entrance to exit of the patient's room. A nurse and a sociologist analyzed further videos. Hand hygiene disinfection as well as gloves and mask wearing in isolation precaution were observed.Results : A total of 756 videos were captures. 249 were rejected because they were not contributive and 507 videos (811 Healthcare workers paths) were analyzed. Healthcare workers had hand disinfection at least one time in the path in 28.2%. Hand disinfection at entrance and exit of the bedroom is respected in 6.2%. The meal tray delivery is associated with a lower hand hygiene practice. The glove wearing adhesion is 51.2% in Clostridium difficile contact precaution, and conformity to protocol is 17.5%. Wearing gloves impairs hand disinfection especially in situation where gloves are not part of the protocol (38.7%). Adhesion to mask wearing in airborne precaution is 90.7%.