Background: Control of nosocomial infections is a major health concern in a hospital setting and hand hygiene is considered as the most important tool in nosocomial infection control. Methods: This prospective study about the practice of hand washing by 106 HCWs (Health Care Workers) working in Intensive Care Unit (ICU) before and after patient contact in a tertiary care hospital was conducted to find out the hand washing compliance rate in ICU of GB Pant Institute of Postgraduate Medical Education and Research and the factors associated with noncompliance and to find out the impact of a task-orientated hand hygiene education and intervention program. Results: 462 opportunities of hand hygiene were observed in the ICUs over 30 h. Adherence was found to be 52%. A positive intention to comply with hand hygiene was found among 94% of the respondents. Most respondents (78.2%) believed that they could improve compliance with hand hygiene on their own. Intervention included education on hand hygiene indications and technique, hand hygiene performance feedback, and discussion of the previous assessment of HCWs' beliefs toward hand hygiene. After intensive promotion of hand hygiene, observation sessions were performed on 98 nursing staff, which provided 425 opportunities of hand hygiene, and hand hygiene adherence was increased to 63% as an impact of measures taken. Conclusions: The study revealed that hand hygiene compliance can be effectively increased among HCWs by regular reminders and surveys. Training programs on hand hygiene should be systematically planned, regularly conducted, and evaluated for staff nurses so as to keep them motivated.

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Introduction: Health care associated infections from invasive medical devices in intensivecare pose the highest risk prolonging the hospital stay and cost for the patients. Ventilator-associated pneumonia (VAP) is an important infection in mechanically ventilated patients.Due to increasing incidence of multidrug-resistant organisms in intensive care units (ICUs),early and correct diagnosis of VAP is an urgent challenge for an optimal antibiotic treatment.Objectives: The aim of this study was to assess the incidence, commonest pathogens, andresistance pattern of isolates of VAP in ICUs of a tertiary care hospital. Material and methods: A prospective study was performed over a period of six months,enrolling patients undergoing mechanical ventilation for >48 h. Endotracheal aspirates andbronchoalveolar lavage samples were collected from patients suspected of VAP and semi-quantitative cultures were performed on all samples. VAP was diagnosed by m-CPIS score (.6). Results: A total of 2369 patients were admitted in ICUs, of which 979 patients were onventilator assistance (4165 ventilator days). Out of these, 47 (4.8%) patients developed VAPand early onset VAP was seen in 66% cases. The VAP rate was 11.03/1000 ventilator days. Thecommonest pathogen was Acinetobacter spp. followed by Pseudomonas spp. and Klebsiella spp.Most of the Acinetobacter spp. were resistant to cephalosporins, ciprofloxacin, and showedmaximum susceptibility to tigecycline and polymyxin B. Conclusions: The early onset VAP was more and incidence was high in males. This studyhighlights the predominance of resistant Gram-negative pathogens in VAP cases. `

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Background: Wound is a disruption of normal anatomic structure and function of the skin, and any infection in this constitutes wound infection. Wound infection delays wound healing, and it causes wound breakdown, leading to increased hospital stay, morbidity and mortality. Most of the published data available focus on surgical site infections. In the developing countries, however, wound infection is an important cause of hospital mortality and morbidity. No data are available on the microbial profile of the wounds presenting at our hospital. Objective: This study was thus designed to describe the microbial epidemiology and the antimicrobial resistance profile of the wounds of the patients presenting to the OPD. Methodology and results: Retrospective review of records of all wound samples sent over 3 years from OPD was done. OPD sent 827 wound samples of 571 patients. Most common organism isolated was Staphylococcus aureus [132 (35%)], followed by Escherichia coli [54 (14%)] and Pseudomonas aeruginosa [49 (13%)]. Of the 145 S. aureus strains, 43 (30%) strains were Methicillin Resistant Staphylococcus aureus, and none were resistant to vancomycin/line- zolid/teicoplanin. Gram-negative organisms were resistant to most antibiotics tested. Conclusion: Wound healing is halted in the presence of prolonged inflammation such as due to infection. Presence of bacteria delays wound healing, but the presence of low number of microbes is required for wound healing. Absence of appropriate signs to guide treatment becomes a reason for prolonged indiscriminate use of antibiotics which leads to rapid emergence of resistant organisms. Data generated by our study would help in the formulation of antibiotic policy for OPDs and also help in checking inadvertent antibiotic usage.

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Aim: To record the knowledge and attitude of dentists in India towards patient safety indentistry. Materials and method: An online questionnaire of 13 questions was prepared to determinedentist's knowledge and attitudes towards patient safety in dentistry. Members of an onlineclosed discussion group of dentists (n = approximately 5000) working in India were contactedon three separate occasions during October 2013–January 2014. Results: 1025 responses were obtained. 19% of respondents stated that they actively tooksteps to improve safety standards but only 8% of the total sample believed that theiremploying organisation or professional body would support them to improve patient safety.In addition, only 8% believed that senior staff members encouraged open discussion onsurgical errors or how to prevent them. 67% of dentists stated that they had inadequateknowledge on patient safety issues and 97% recommended that patient safety in dentistry begiven a higher priority in the undergraduate dental curriculum. Conclusion: There is a need to improve knowledge about patient safety in dentistry amongdentists in India and to create a more open culture in reporting adverse incidents.

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Background: The risk of surgical site infection (SSI) is approximately 1–3% for elective surgery and more for emergency surgeries. Apart from patient endogenous factors, the role of external risk factors in the pathogenesis of SSI is well recognized. However, among the various measures to prevent SSI, only some are based on strong evidence, and there is insufficient evidence to show whether one method is superior to any other. Therefore, this study was carried out to find out the various factors causing post-operative wound infection, the commonly associated microorganisms, and antibiotic sensitivity and resistance pattern. Methods: The study was conducted in tertiary care hospital, Pondicherry between September 2012 and September 2014. All the patients who underwent emergency surgeries in the Department of General Surgery were included in the study. An elaborative clinical study of post-operative wound infection was conducted. The suture site was inspected for any sign of infection starting from the second post-operative day till discharge from hospital. Wound swabs were collected and sent for aerobic culture and sensitivity. Results: In this study, open appendectomy was the most common surgery that was performed on an emergency basis. Anemia followed by hypoalbuminemia were the two important comorbid conditions. The rate of infection for clean-contaminated, contaminated, and dirty wound were 16.88%, 38%, and 20% respectively. Conclusion: SSI occupies a significant proportion among various hospital-acquired infections. SSI not only prolongs the hospitalization but also markedly increases the expenditure and morbidity.

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