Hospital-acquired infections affect millions of patients worldwide each year and result in massive preventable healthcare costs. Many of the organisms that cause these infections survive on routine healthcare equipment and are easily transmitted from patient to patient when healthcare professionals and facilities do not comply with infection prevention and control practices. They are particularly dangerous for high-risk patients and patients in intensive care units. Hence the present study involved the implementation of an infection control protocol to reduce these nosocomial infections. Guidelines for infection control in our hospital setting were formulated by the infection control team in the year 2010. These guidelines were periodically revised to improve the compliance of infection control measures. Additionally, regular auditing of the prescribed antibiotic further minimized the high end and reserved antibiotic use thereby further reducing the nosocomial infection rate. Data regarding the infection rates were collected from the intensive care units and were calculated for the site-specific nosocomial infection. It is observed that 17.6% reduction in the nosocomial infection rate was over a period of 7 years. Additional analysis of the site-specific nosocomial infection rate revealed a 5.2, 12.2, 10.5, and 5.7% reduction in ventilator-associated pneumonia, catheter-related urinary tract, bloodstream, and surgical site infection rate. The results of the present study showed an improved compliance rate with the infection control guidelines which facilitated the control of nosocomial infection rates thereby reducing the hospital costs, total patient days and the mortality rate.

: Blood cultures are a proven gold standard method for the identification of causative agents of bloodstream infections. Identification of causative organism along with antibiotic susceptibility plays a pivotal role in proposing suitable antibiotic therapy. Automated blood culture systems show improved monitoring of blood cultures by reducing the time and by ensuring more accurate results when compared to the conventional blood culture system. To isolate the organism from given blood samples of a suspected case of septicemia and to compare the results of conventional and automated blood culture systems and to study the antimicrobial susceptibility pattern of the pathogens isolated. A prospective study of 6 months period was conducted among 100 subjects attending the Department of Microbiology in a tertiary care hospital. Subjects with symptoms and signs of septicemia were included. 25ml of venous blood was drawn aseptically from the venipuncture site, of which 5ml of blood was inoculated into 50ml of Brain Heart Infusion bottle in conventional blood culture system and 10ml each into aerobic and anaerobic BACTEC PLUS bottle in Automated blood culture system BACTEC FX40. Overall, 48% and 60% of the samples revealed positive growth by the conventional and automated blood culture system BACTEC FX40, respectively. Gram Positive Cocci were 52.08% and Gram Negative Bacilli were 47.91% isolated by conventional blood culture system, whereas automated blood culture system BACTEC FX40 isolated 45% and 55%, respectively. Isolates were detected within 24-48hrs and 12-24 hrs by conventional and automated blood culture systems, respectively. The anti-microbial susceptibility pattern of the pathogens isolated was also recorded by Kirby Bauer disc diffusion method of antimicrobial susceptiblity testing. Automated blood culture systems are a trustworthy substitute to conventional blood culture systems. The automated blood culture systems being more sensitive and rapid in detecting septicemia in subjects acts as an appropriate means for the initial identification and detection of blood pathogens and improved provision of antimicrobial therapeutic options for septic Patients especially in Critical Care and Intensive Care Units where positive culture reporting is crucial.

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Rapidly rising antibiotic resistance is a challenge to comprehensive patient care in all branches of medical science. A retrospective observational study was conducted to determine the antimicrobial resistance patterns in a tertiary care hospital for six months. The data was collected from laboratory test reports and patient case files using a structured data collection form. A total of 200 cases having a positive culture report were included in the study.  Of these, 186 cases were identified to have gram-negative infections, and 14 had gram-positive infections. Escherichia coli (E. Coli) (47%) was the predominant isolate among gram-negative organisms, followed by Klebsiella (24.5%), Pseudomonas (7.55%), Enterobacter (6.5%), and Citrobacter (4.5%). All Gram-positive organisms E.coli, Klebsiella, Pseudomonas, Enterobacter have shown maximum resistance of 92.55%, 95.91%, 93.33%, and 76.92%, respectively, Ampicillin. E.coli has shown the least resistance to carbapenems (7.44%). Klebsiella demonstrated minimum reistance of 10.2% to cefotaxime, cefazolin and levofloxacin. Pseudomonas was completely sensitive to piperacillin-tazobactam. Enterobacter showed least resistance to gentamicin (3.07%) and piperacillin-tazobactam (3.07%). The primary gram-positive isolate, Enterococcus spp. (5.5%) mainly was resistant to ciprofloxacin (90.90%), followed by levofloxacin (81.81%), tetracycline (81.81%), and gentamicin (72.72%). E. coli was the most resistant organism in the present study. The study results would contribute to the development of an antibiogram at the study site.

Nosocomial or hospital acquired infections are acquired by the patients during hospital stay. Bacteria were found to be responsible for the majority of infections followed by fungi, viruses, and protozoa. Literature has demonstrated that hospitals with infection control guidelines help reduce infection rates. We therefore isolated and compared common nosocomial organisms causing infections previous to and after the implementation of infection control measures to control healthcare-associated infections in our hospital setting. Strategy for infection control in our hospital setting was devised in the year 2010. These guidelines were frequently revised to improve the compliance of infection control measures. Infection control nurse helped record all the positive cultures in a surveillance format. This data on the number of isolates recovered from the cultures was documented and compared each year to check for the compliance of the infection control guidelines to reduce microbial isolates causing infections. Of the recovered 866 isolates from microbial cultures known to be causing nosocomial infections, 77.7% were gram-negative bacteria, 13.2% were gram-positive bacteria and 9% were fungi. A decrease in the number of microbes causing infections was observed after the implementation of infection control measures, with only 3.4% of the gram-positive microbes, 9.6% of the gram-negative microbes and 3.8% of the fungi being identified in the year 2017. Our study demonstrated that effectively devised infection control measures help reduce the number of organisms causing nosocomial infections further resulting in decreased infection rate.