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.
Background:Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections represent significant public health issues globally. They are important causes of morbidity and mortality in hemodialysis patients. Patients with HBV/HCV co-infection have a higher risk of progression to cirrhosis and decompensated liver disease and have an increased risk of hepatocellular cancer (HCC). Because the two hepatotropic viruses share same modes of transmission, co-infection with the two viruses is not uncommon, especially in areas with a high prevalence of HCV infection and among people at high-risk for parenteral infection.Aims:To estimate the prevalence of HBV and HCV co-infection among hemodialysis patients.Materials and Methods:This retrospective, single centered hospital record-based study was carried out in a tertiary care hospital in Faridkot (Punjab), India. All the patients who underwent hemodialysis from January 2013 to December 2014 were included in the study. Patients of all age groups were tested for anti-HCV antibodies by fourth Generation HCV Tridot ELISA (J. Mitra & Co. Pvt. Ltd., New Delhi, India) and for hepatitis B surface antigen (HBsAg) by Hepalisa (J. Mitra & Co. Pvt. Ltd).Results:Of the total 262 patients on hemodialysis, 88 (33.5%) were found to be having HCV infection, 4 (1.5%) were found to be positive for HBsAg. Co-infection with HBV/HCV was observed in 2 (0.8%) patients. Out of the total 92 patients having HBV and HCV infection, 62 (67.4%) were males and 30 (32.6%) were females. The majority of the patients were found to be of 41-60 years of age (41.3%) followed by 21-40 years (31.5%) and thereafter in 61-80 years (23.9%) and lowest prevalence was observed in the age group of <20 years (2.2%) and >80 years (1.1%).Conclusion:The risk of co-infection is greater among the chronic renal failure (CRF) patients due to the high frequency of transfusions of blood/blood products and extracorporeal circulation during hemodialysis. Patients with HBV/HCV co-infection have a higher risk of progression to cirrhosis and decompensated liver disease and further have an increased risk of HCC. In our study, out of the total 262 patients, 88 (33.5%) were found to be having HCV infection, 4 (1.5%) were found to be positive for HBsAg and dual infection was observed in 2 (0.8%) patients which is higher than the rates reported from different studies all over the world and India.
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