Standard Infection Control Practices Research Articles

Nurses' knowledge and adherence perception to standard infection control practices; Single Centre Experience

Nurses' knowledge and adherence perception to standard infection control practices; Single Centre Experience

An Assessment of Compliance with Infection Control Protocols amongst Dental Health Care Personnel in a Tertiary Health Facility in Southern Nigeria.

Dental practitioners are at a very high risk of cross infection due to multiple exposures with patients who may be asymptomatic carriers of infectious diseases. The study focused on Dental Health Care Personnel who are presently working in the Dental Centre of the University of Benin Teaching Hospital (UBTH) and it assessed the compliance to infection control practices. A self-administered questionnaire containing closed and open-ended questions was used. Information sought included; socio-demographic characteristics of respondents, duration as DHCP, knowledge of transmissible infections in dental clinics, level of compliance with infection control protocols and reasons for non-compliance. One hundred and thirty-five (135) Dental Health Care Personnel of the University of Benin Teaching Hospital were enrolled for this study. However, a total of one hundred and eleven questionnaires were properly filled and returned for analysis, giving a response rate of 82.2%. Fifty-two (46.8%) respondents, had good compliance, twelve (10.8%), had fair compliance and forty-seven (42.3%) had poor level of compliance. Although, the average level of compliance of the DHCP of UBTH was good, some basic important principles were not being observed. The study concludes in the affirmative that strict observance of standard infection control practices is possible.

A Review of Current Literature of Interest to the Office-Based Anesthesiologist

A Review of Current Literature of Interest to the Office-Based Anesthesiologist

Impact of COVID-19 pandemic on incidence of health-care associated infections in neurology intensive care unit (ICU) and its associated mortality – A retrospective cohort study

Health care-associated infections (HCAI) are leading cause of mortality in Intensive Care Unit (ICU). The coronavirus disease 2019 (COVID-19) pandemic has led to mandatory use of masks and personal protective equipment (PPEs) in addition to standard infection control practices. This may additionally lead to benefit in the decrease of HCAI besides decreased risk of transmission of COVID-19. Aim: To compare the incidence of HCAIs and in-hospital mortality among patients admitted in the neurology ICU during the COVID-19pandemic period and pre-pandemic period.

Sources of SARS-CoV-2 and Other Microorganisms in Dental Aerosols

On March 16, 2020, 198,000 dentists in the United States closed their doors to patients, fueled by concerns that aerosols generated during dental procedures are potential vehicles for transmission of respiratory pathogens through saliva. Our knowledge of these aerosol constituents is sparse and gleaned from case reports and poorly controlled studies. Therefore, we tracked the origins of microbiota in aerosols generated during ultrasonic scaling, implant osteotomy, and restorative procedures by combining reverse transcriptase quantitative polymerase chain reaction (to identify and quantify SARS-CoV-2) and 16S sequencing (to characterize the entire microbiome) with fine-scale enumeration and source tracking. Linear discriminant analysis of Bray-Curtis dissimilarity distances revealed significant class separation between the salivary microbiome and aerosol microbiota deposited on the operator, patient, assistant, or the environment (P < 0.01, analysis of similarities). We also discovered that 78% of the microbiota in condensate could be traced to the dental irrigant, while saliva contributed to a median of 0% of aerosol microbiota. We also identified low copy numbers of SARS-CoV-2 virus in the saliva of several asymptomatic patients but none in aerosols generated from these patients. Together, the bacterial and viral data encourage us to conclude that when infection control measures are used, such as preoperative mouth rinses and intraoral high-volume evacuation, dental treatment is not a factor in increasing the risk for transmission of SARS-CoV-2 in asymptomatic patients and that standard infection control practices are sufficiently capable of protecting personnel and patients from exposure to potential pathogens. This information is of immediate urgency, not only for safe resumption of dental treatment during the ongoing COVID-19 pandemic, but also to inform evidence-based selection of personal protection equipment and infection control practices at a time when resources are stretched and personal protection equipment needs to be prioritized.

Nosocomial Infection Surveillance in Neonatal Intensive Care Units of Bahrami Children’s Hospital

Background: Nosocomial Infection (NI) is one of the leading causes of short- and long-term morbidity and mortality among neonates, especially in Neonatal Intensive Care Units (NICUs). Objectives: We aimed to evaluate the epidemiology of NIs and associated factors. Methods: From March 2017 to September 2018, all the neonates who were admitted to the NICUs of Bahrami Children’s Hospital were enrolled. Nosocomial infections were identified based on the definition of CDC-NNIS. Demographic, clinical, and laboratory data of the patients were extracted from the medical records. Results: A total of 979 neonates were admitted to the NICU, of whom 60 were diagnosed with NI. The incidence of NI was 6.1 per 100 hospitalized patients. The most prevalent NI was bloodstream infection (30%), followed by pneumonia (21.7%). The most frequent presentations were respiratory distress (31.7%) and poor feeding (26.7%). Major pathogens were Gram-positive bacteria such as Staphylococcus aureus (25.7%) and coagulase-negative staphylococci (25.7%). The mean hospital stay was 25.2 ± 20.89 days. The mortality rate of patients with NI was 16.7%. The factors associated with an increased risk of mortality among patients with NI were a lack of ventilation support, low birth weight, and WBCs with an abnormal range. Conclusions: The results of the present study showed that the incidence of NI was high, and the cultures collected from body fluids had a particular role in the diagnosis and treatment of NI. Standard infection control practices should be applied to reduce the incidence of NI and subsequent morbidity and mortality.

Dissemination mechanisms of NDM genes in hospitalized patients.

BackgroundNDM-producing Enterobacteriaceae are a major clinical concern worldwide. We characterized NDM-positive pathogens isolated from patients and assessed the dissemination patterns of the blaNDM genes in a hospital setting.MethodsEleven NDM-positive Enterobacteriaceae (three Enterobacter hormaechei, six Klebsiella pneumoniae and two Escherichia coli) were isolated from nine patients over a 1 year period. Antimicrobial susceptibility was assessed by MICs. A combination of short- and long-read WGS was used for genome analysis. Clinical treatment history of patients was linked with genetic features of individual isolates to investigate the dissemination patterns of the blaNDM genes and NDM-positive strains.Results bla NDM in clonal K. pneumoniae were transmitted between two patients. In other instances, an identical IncC plasmid encoding NDM-1 was transmitted between E. coli and K. pneumoniae isolated from the same patient, and an IncX3 plasmid, carrying blaNDM-1 or blaNDM-5, was harboured in non-clonal E. hormaechei. Varying patterns of IS elements were identified as a critical transmission mechanism in association with blaNDM genes.ConclusionsMultiple transmission patterns were identified in hospitalized patients, including dissemination of clonal bacterial strains carrying resistance genes and horizontal transfer of resistance genes among divergent bacterial strains. Controlling spread of NDM is complex: while attention to standard infection control practices is critically important, this needs to be matched by aggressive efforts to limit unnecessary antimicrobial use, to minimize the selection for and risk of transfer of ‘high mobility’ resistance genes among Enterobacteriaceae.

Nipah Virus Infection

Nipah virus is a type of RNA virus and this virus may usually circulate among specific types of fruit bats. In the year 1998, this disease was first identified by a team of scientists at the Faculty of Medicine, University of Malaya in Malaysia and the disease was named after a village called Sungai Nipah in Malaysia. The out breaks of Nipah virus infection have been reported in Malaysia, India, Singapore, Bangladesh and Philippines. Typically, the spread requires direct contact with an infected source. Through the oro-nasal route, the virus enters its host and causes the infection. From the terminal stages of the disease, human tissues have only been studied and the site of the initial replication was found to be unknown. After the exposure of the virus, it may take 5-14 days for the onset of the symptoms. The symptoms of Nipah virus infection can be fever, headache, cough, shortness of breath and confusion. This review article was mainly focused in describing various aspects of Nipah virus infection. Human to human nosocomial infections can be prevented by strictly following the standard infection control practices. Implementation of infection control practices like isolation of patients, good hand hygiene practices and the use of personal protective equipments may help us in the prevention of person to person transmission. Health care workers exposed to the suspected Nipah virus patients must inform their higher officials and should undergo testing for the Nipah virus. Discourage the funeral practices that require the direct contact with the remains.

Prevention of hospital-acquired infections: A construct during Covid-19 pandemic.

Introduction:Hospital-acquired infection (HAI) rates were reported to have declined in healthcare settings during the Covid-19 pandemic. Needless to mention that HAI is of paramount interest and relevance to a primary care physician who need to care from womb to tomb inside pandemic.Objectives:This study was conducted to find the impact of Covid-19 pandemic on the four parameters of HAIs, namely, catheter-associated urinary tract infections (CAUTI), central-line-associated bloodstream infections (CLABSI), ventilator-associated pneumonia (VAP) and surgical site infections (SSIs) with hand hygiene compliance rates among healthcare workers.Materials and Methods:This retrospective data mining was undertaken in a 700 bed multispecialty teaching hospital in the Eastern India which was a Government of Bihar approved speciality Covid Care Hospital. Data from the monthly routine infection control monitoring and surveillance activities was collated from January 2019 to December 2020. Control charts with upper and lower control limit set at mean ± 1 SD were used to monitor monthly trends of HAIs.Results:The CAUTI rates reduced by 28.01%; the CLABSI rates declined by 37.61%, the SSI rates reduced by 62.39%, while the highest VAP rates were reported in November 2019 (1.9 per 1000 ventilator days). The hand hygiene compliance rates from January 2019 to December 2020 among different healthcare staffs showed a sharply rising trend.Conclusion:Covid-19 pandemic highlighted paramount importance regarding compliance to hand hygiene and implementation of standard infection control practices as recommended by World Health Organisation and Centres for Diseases Control and Prevention (CDC), which can drastically reduce range of HAIs.

Prevalence of Vancomycin Resistant Enterococci (VRE) in Catheter Associated Urinary Tract Infections(CAUTI) with special reference to biofilm formation

Introduction: Enterococci have been recognized as an important cause of hospital-acquired infections. They are currently the second most common organisms recovered from nosocomial urinary tract infection. Emergence of Vancomycin resistance has been a threat in the hospital settings. Biofilm formation is also an important virulence factor contributing to drug resistance. Aim: To know the prevalence of VRE in device infections CAUTI and role of biofilm formation in the associations of CAUTI. Materials and Methods: Total 100 Catheter-Associated Urinary Tract Infection (CAUTI) cases were included. Controls comprised of 50 cases of UTI but non-catheterized. Bacteriological identification and susceptilibity testing were done as per standard protocol. Results: Overall culture positivity in CAUTI was 32%. Enterococci (40.62%) were the predominant pathogens followed by E.coli (37.50%). VRE prevalence in current study was 18.75%. Strong biofilms were mainly produced by resistant isolates(30.76%). Biofilm formation by VRE was statistically significant (p value= 0.01124). VRE infection was also more common in CAUTI (p value= 0.000019). Conclusion: VRE detection and its control entail an aggressive approach which involves strict adherence to standard infection control practices by the hospital personnel. Role of the Microbiology Laboratory plays important role in the Detection, Reporting and Control of VRE. Collaboration between the laboratory and the infection-control program will definitely play an important role in this. Keywords: Enterococci, VRE, CAUTI, Biofilm.

The experience of the health care workers of a severely hit SARS-CoV-2 referral Hospital in Italy: incidence, clinical course and modifiable risk factors for COVID-19 infection.

BackgroundDuring the COVID-19 pandemic, the health care workers (HCWs) at the frontline have been largely exposed to infected patients, running a high risk of being infected by the SARS-CoV-2 virus.Since limiting transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in health care setting is crucial to avoid the community spread of SARS-CoV-2, we want to share our experience as an early hit hospital where standard infection control practices have been conscientiously applied and effective. We believe that our example, as first and hardest hit country, might be a warning and aid not only for those who have been hit later, but also for a second fearful wave of contagion. In addition, we want to offer an insight on modifiable risk factors for HWs-related infection.MethodsDemographic, lifestyle, work-related and comorbidities data of 1447 HCWs, which underwent a nasopharyngeal swab for SARS-CoV-2, were retrospectively collected. For the 164 HCWs positive for SARS-CoV-2, data about safety in the workplace, symptoms and clinical course of COVID-19 were also collected. Cumulative incidence of SARS-CoV-2 infection was estimated. Risk factors for SARS-CoV-2 infection were assessed using a multivariable Poisson regression.ResultsThe cumulative incidence of SARS-CoV-2 infection among the screened HCWs was 11.33% (9.72–13.21). Working in a COVID-19 ward, being a former smoker (versus being a person who never smoked) and BMI was positively associated with SARS-CoV-2 infection, whereas being a current smoker was negatively associated with this variable.ConclusionsAssuming an equal accessibility and proper use of personal protective equipment of all the HCWs of our Hospital, the great and more prolonged contact with COVID-19 patients remains the crucial risk factor for SARS-CoV-2. Therefore, increased and particular care needs to be focused specifically on the most exposed HCWs groups, which should be safeguarded. Furthermore, in order to limit the risk of asymptomatic spread of SARS-CoV-2 infection, the HCWs mild symptoms of COVID-19 should be considered when evaluating the potential benefits of universal staff testing.

Dissemination Mechanisms of New Delhi Metallo-β-lactamase Genes in Hospitalized Patients

Background: New Delhi metallo-β-lactamase (NDM) producing Enterobacteriaceae is a major clinical concern worldwide. We characterized NDM-positive pathogens isolated from patients and assessed the dissemination patterns of the blaNDM genes in a hospital setting. Methods: Eleven NDM positive Enterobacteriaceae (three Enterobacter hormaechei, six Klebsiella pneumoniae and two Escherichia coli) were isolated from nine patients over a one-year period. Antimicrobial susceptibility was assessed by minimum inhibitory concentrations. A combination of short- and long-read whole genome sequencing was used for genome analysis. Clinical treatment history of patients was linked with genetic features of individual isolates to investigate the dissemination patterns of the blaNDM genes and NDM-positive strains. Findings: blaNDM in clonal K. pneumoniae were transmitted between two patients. In other instances, an identical IncC plasmid encoding NDM-1 was transmitted between E. coli and K. pneumoniae isolated from the same patient, and the same IncX3 plasmid, carrying blaNDM-1 or blaNDM-5, was harbored in E. hormaechei. Varying patterns of insertion sequence (IS) elements were identified as a critical transmission mechanism in association with blaNDM genes. Interpretation: Multiple transmission patterns were identified in hospitalized patients, including dissemination of clonal bacterial strains carrying resistance genes, and horizontal transfer of resistance genes among divergent bacterial strains. Controlling spread of NDM is complex: while attention to standard infection control practices is critically important, this needs to be matched by aggressive efforts to limit unnecessary antimicrobial use, to minimize the selection for and risk of transfer of “high mobility” resistance genes among Enterobacteriaceae. Funding Statement: This project is part of the University of Florida’s “Creating the Healthiest Generation” Moonshot initiative, which is supported by the UF Office of the Provost, UF Office of Research, UF Health, UF College of Medicine, and UF Clinical and Translational Science Institute. Declaration of Interests: KC reports grants from Arrow International, Inc. and National Institute of Health - Antibiotic Research Leadership Group and personal fees from BioFire diagnostics for travel and speaker. All other authors declare no competing interests. Ethics Approval Statement: IRB-approved study at the University of Florida.

Honesty Is the Best Policy

Honesty Is the Best Policy

Knowledge regarding Infection Prevention and Control guidelines during COVID 19 pandemic among health care workers in tertiary care hospital.

Background The COVID-19 pandemic has taken tragic proportions and has disrupted lives globally. Understanding the risks associated with severe acute respiratory syndrome corona virus 2 SARSCoV-2 transmission during health care delivery and assessing mitigation strategies for hospitals to improve patient safety and access to health care is crucial. Guidelines for triage governmental guidelines for use of personal protective equipment PPE from doctorrsquos point of view precautions to be taken in the OPD and operating room as well as care of various equipments in the meanwhile the role of waste management sector in the hospitals also play an important role in ensuring unusual heaps of waste generated in hospitals during this pandemic thus controlling the spread of COVID19 infection. All these should be assessed to see if standard infection control practices and waste management protocol are being followed properly.Objective To assess knowledge among healthcare workerspostgraduates and interns about infection control in Victoria hospital during COVID-19 pandemic.Methodology It was an online cross-sectional survey among 80 healthcare workers in Victoria hospital in Bengaluru. A pre-tested semi structured self-administered questionnaire was used.Results More than half of the respondents reported being screened daily for temperature monitoring before entering the hospital premises. Only few reported that they were confused about the right sequence of donning and doffing of PPE kit.Conclusion Repeated training of the health care staff is very crucial for proper implementation of infection control practices and biomedical waste management.nbsp

Minimizing the risk of international spread of coronavirus disease 2019 (COVID-19) outbreak by targeting travelers

The Coronavirus Disease-2019 (COVID-19) outbreak has become a global health emergency owing to its magnitude, attributed deaths, and its propensity to spread across the world. In-fact, owing to its quick spread across international boundaries and the resulting caseload, the disease has been declared as a Public Health Emergency of International Concern on 30 January 2020. It is worth noting that out of the 395 cases detected in other nations, 165 (41.8%) have a positive history of travel to China. As of now, the World Health Organization has not recommended for any restrictions on the travel or trade aspects, but has clearly specified that implementation of International Health Regulations should be strictly done at the airports and seaports. In conclusion, the COVID- 19 outbreak has created an alarm across the globe as the causative virus is novel in nature. However, strengthening of standard infection control practices and adoption of preventive measures for travelers can significantly minimize the threat of further transmission of the disease.

Critical Care Nurses as Frontline Warriors During COVID-19 in Pakistan

BackgroundThe COVID-19 pandemic resulted in several short-term and long-term impacts on the physical, social, and psychological health of every individual globally, especially among frontline workers including nurses working in the critical care settings. In Pakistan, 85,264 confirmed cases have been identified and 1,770 deaths are reported so far. The death rate is 2.0% as compared to Europe (14.6%) and the United States (5.7%) per 100,000 population. Frontline workers are the most vulnerable population during this pandemic. Nearly 440 frontline staff including nurses, doctors, and other health workers have been infected with COVID-19 with 8 confirmed deaths reported in different provinces of Pakistan. These numbers are continuously increasing posing a serious threat for the health and well-being of the healthcare professionals especially nurses working in the critical care settings.ObjectiveThe paper outlines the challenges and experiences of critical care nurses working in acute hospital settings of a low resourced country Pakistan during a pandemic.MethodsLiterature search using CINAHL, MEDLINE, PubMed databases, local and international news papers, magazines, websites, international nursing colleagues and personal experiences/insights are included in the paper.ResultsFindings include common challenges such as lack of staff, lack of personal protective equipment (PPE), limited knowledge regarding standard infection control practices, isolation protocols, lack of administrative support, transportation, accommodation, childcare facility, and so forth. As a result, most nurses are reporting symptoms of fear, anxiety, depression, post-traumatic symptoms, spiritual, and moral distress. Nurses often become targets of violence and harassment by the general public in the Pakistani healthcare system, due to lack of awareness, cultural beliefs, low status/image of nurses, low literacy levels, and poverty.ConclusionTargeted interventions and policies are needed to maintain safety and protect physical, social, psychological, and spiritual health and well-being of nurses. Health authorities in Pakistan should take the responsibility in creating awareness, providing adequate guidance, and support to enhance nurses' well-being and quality of life during the pandemic.

2787. Respiratory Syncytial Virus in Elderly Adults

BackgroundThe role of respiratory viruses other than influenza in acute respiratory tract infections (ARTI) among elderly adults has probably been underestimated. Recent advances in molecular diagnosis have made the rapid identification of RSV infection possible.The aim of our study was to assess the role of RSV in patients older than 65 years.MethodsProspective observational study (April 2018–February 2019) conducted in a 137-bed institution in Buenos Aires, Argentina. All consecutive elderly patients (>65 years) admitted with ARTI were included. Clinical and laboratory parameters as well as nasopharyngeal swab for respiratory viruses were obtained. Blood cultures and sputum collection, were analyzed. Viral detection was performed according to CDC real-time RT–PCR assay. All patients underwent clinical follow-up during hospitalization and up to 30 days after discharge.ResultsA total of 124 patients were recruited (mean age 82 years; range: 65–98) 58% female. Clinical diagnosis at admission were: community-acquired pneumonia 90 (72%), COPD exacerbation 11 (9%), acute bronchitis 10 (8%), healthcare-associated pneumonia 8 (7%) influenza like síndrome 5 (4%). Blood cultures were obtained in 92 patients: 4 positives for Streptococcus pneumoniae, 3 E. coli, 2 SAMS, 1 Klebsiella pneumoniae. Sputum was obtained in 20 patients, none were positive.The viral results of the124 samples were: RSV 13 (10.4%), Influenza B 9 (7.2%), Influenza A 8 (6.4%).Regarding RSV positive patients, the mean age was 87 years and 69% were female. 30 % had history of heart failure and 30 % had history of COPD. Clinical diagnosis on admission were: CAP 10 (77%), COPD exacerbation 2 (15%) and bronchitis 1 (8%). Non productive cough was present in 46% and bronchospasm in 85%. Mean time of hospitalization was 9 days (R: 4–16) and fever duration 1 day (R: 0–2). The median duration of antibiotic treatment was 9.5 days (R: 4 to 15) No viral nor bacterial coinfections were observed. No early mortality was registered, global mortality was 23% (3 patients). Death was clinically related to RSV infection.ConclusionThis study suggest that RSV is a relevant respiratory pathogen in the elderly population, with significant associated morbidity and mortality rates. Current treatment is limited to supportive care and prevention to standard infection control practices. A new approach is needed to improve RSV infection management.Disclosures All authors: No reported disclosures.

Tactics to Prevent Intra-Abdominal Infections in General Surgery.

Abdominal infections following surgery have many severe consequences. Several effective, well-evaluated infection prevention and control processes exist to avoid these infections. This manuscript reviews and provides supporting evidence for common management strategies useful to avoid postoperative abdominal infection. Prevention of abdominal infection begins with preparation of the environment using standard infection control practices. Peri-operative use of systemic antibiotics, an antibiotic bowel preparation in colorectal surgery, and effective antiseptic preparation of the surgical site all reduce infection rates. Peri-operative supplemental oxygenation, maintenance of core body temperature, and physiologic euglycemia will reduce both incisional and organ-space infections in the abdominal surgery patient. Strategic use of irrigation and drain placement may be useful in some circumstances. Specific methods of prevention are documented to reduce intra-abdominal infections. Prevention requires a multi-disciplinary team including the surgeon, anesthesiologist, and all operating room personnel.

Transferring knowledge into practice: a multi-modal, multi-centre intervention for enhancing nurses' infection control competency in Bangladesh

Nurses are considered as the key to infection prevention as they play a major role in treatment as well as taking care of patients. To assess the role of a multi-modal intervention (MMI) in improving nurses' competency and adherence to standard infection control practices in Bangladesh. The study adopted a pretest-post-test intervention approach, in three different periods (from 2012 to 2017) in five hospitals (two public, two private, and one autonomous) in Bangladesh. Each study period was divided into three phases: pretest, MMI, and post-test. Data were collected on 642 nurses using direct observation method through a structured checklist. After implementing the MMI, overall hand hygiene compliance significantly increased before patient contact (from 1.3% to 50.2%; P<0.000) and after patient contact (from 2.8% to 59.6%; P<0.000). Remarkable improvements were also achieved in adherence to use of gloves (from 14.6% to 57.6%; P<0.000), maintaining sterility of equipment during aseptic techniques (from 34.9% to 86%; P<0.000), biomedical waste segregation (from 1.8% to 81.3%; P<0.000) and labelling of procedural sites (from 0% to 85.7%; P<0.000). Moreover, needlestick injury rate notably decreased (from 6.2% to 0.6%; P<0.000). MMI can play a vital role in improving nurses' compliance with the standard infection control practices. Such context-specific interventions, which are crucial for preventing healthcare-associated infections and for decreasing occupational hazards, should be replicated in resource-poor countries for achieving universal health coverage by 2030.

Antimicrobial resistance profile of Methicillin-resistant Staphylococcus aureus colonizing the anterior nares of health-care workers and outpatients attending the remotely located tertiary care hospital of North India.

INTRODUCTION:Resistance to antimicrobial agents is a major concern worldwide and is exemplified by the global spread of the Methicillin resistant Staphylococcus aureus (MRSA). Health care workers (HCWs) and asymptomatically colonized patients are important sources of nosocomial MRSA infections.AIMS AND OBJECTIVES:To determine the prevalence of MRSA colonisation, two hundred HCWs and 200 consecutive outpatients attending our tertiary care hospital were studied.MATERIAL AND METHODS:Two sterile pre-moistened cotton tipped swabs were used to collect specimens from their anterior nares. These were inoculated immediately on Blood agar with oxacillin, Mannitol salt agar with oxacillin and CHROM agar. Resistance to cefoxitin was confirmed by PCR by demonstration of mecA gene. Antibiotic susceptibility was determined by Kirby Bauer's disc diffusion method and MIC of vancomycin by using broth dilution and Vitek-2 Compact system.RESULTS:The nasal carriage of MRSA among HCWs was found to be 7.5% and in outpatients 3%. All strains of MRSA from HCWs and outpatients grew on three selective media and mecA gene amplified in all of them. All the isolated strains of MRSA showed high degree of resistance to co-trimoxazole (93.3%), ciprofloxacin (80%) and erythromycin (66.66%). However, there was 100% susceptiability to vancomycin, teicoplanin, linezolid and Rifampicin.CONCLUSION:Although a direct casual relationship could not be established, it could be assumed that the transmission from colonised health care worker is responsible atleast in part for MRSA infection among patients. Therefore emphasis should be laid on strict implementation of standard infection control practices which would help in minimizing the carriage and transmission of MRSA in the hospital.