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The monkeypox virus, which causes the viral zoonotic disease, is known as the most significant orthopoxvirus infection following the elimination of smallpox. The monkeypox virus, which was previously exclusive to West and Central African nations and caused endemic diseases in monkeys and people, has recently been linked to human infections in non-endemic areas including the United States of America (USA) and more than 30 additional countries. Guidelines for the diagnosis and treatment of monkeypox have also recently been made available by the Ministry of Health and Family Welfare of India and the Indian Government. The monkeypox outbreak continues to be a worldwide health emergency, the highest degree of alert recognised by the World Health Organization. The Centers for Disease Control and Prevention (CDC) advises vaccination for those who have been exposed to the disease as well as those who may be at higher risk of contracting it, such as those who have been identified by public health officials as a contact of someone who has the disease.

Objective:-Hepatitis B is noteworthy medical issues that may include the late continuation of liver cirrhosis and hepatocellular carcinoma. The present study aimed to know the seroprevalence of hepatitis B Virus in Meerut with different clinical conditions. Methods: The studyconducted on 4927 patients in Meerut, India, which was performed in central research center labortory of Microbiology at netaji subhash Chandra Bose Medical College and Hospital Between January 2013 to April 2017 The sera were separated and screened for HBsAg byimmune-chromatographic card test then HBsAg positive serum sampleswere tested again for HBsAg using ELISA kit. Positive samples for HBsAgwere tested for HBeAg ELISA kit. Results: In 245 positive cases 118 (48.16 %) were male and 127 (51.84%) were female. The seroprevalence rate of HBV was 4.97% in Meerut, India. Age group21–30 was the highest seroprevalence (7.46%) when compaired to other age group. Of the 245 HBsAg Positive case 55 (1.12%) were HBeAg positive. 20 were male, Highest HBeAg positive male were found in 21- 30age group. Out of 55 HBeAg cases, 35 were female and 92 female were negative for HBeAg, this was stastically significant (P< 0.039) by using Z test. Conclusions: The study uncovered that the seroprevalence of HBV was alarmingly higher in such a populace, which presumably mirrors a high foundation predominance of HBV contaminations ought to be mulled over and Implementation of group based preventive measures and enhanced procedures for safe blood supply may demonstrate valuable to diminish the seroprevalence Bangladesh Journal of Medical Science Vol.18(2) 2019 p.329-333

Background: Genetic changeability of hepatitis B virus (HBV) signifies a challenge for the sensitivity of immunologic and molecular diagnostics. Therefore, knowing the spread of HBV genotypes (GENs) and mutation has considerable impacts on treatment strategies, vaccination program, diagnosis, and prevention. The present study aimed to detect HBV GENs and mutants in HBsAg-positive patients. Methods: The study conducted on 4927 patients in Meerut, India, between March 2013 and April 2017. The blood specimens were analyzed for HBsAg using an ELISA kit, then the blood samples from HBsAg-positive patients were subjected to HBeAg assay and DNA isolation. Amplification of the HBV DNA of pre-S gene and pre-core or basal core promoter region were performed by RT-PCR and sequenced to analyze both GEN and mutation. Results: According to the results, 245 cases were positive for HBsAg, and 55 were HBeAg-positive. With regard to HBV DNA levels, 16 samples were found positive in PCR assay with 7 (43.8%) less than 2000 IU/mL, 4 (25%) between >2000 and 20,000 IU/mL, and 5 (3.25%) >20,000 IU/mL. No mutations were detected in GENs B and A. The prevalence of HBV GENs B and A were 68.8% (n = 11) and 31.25% (n = 6), respectively. Conclusion: GEN-B was more prevalent in comparison to GEN-A. The genetic diversity of HBV and distribution of its GENs and mutation improve the current knowledge of epidemiological, clinical and virological patterns of hepatitis B in this region, which help physicians to prescribe proper antiviral/interferon therapy according to current genotyping pattern.

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The rise in super bugs causing Ventilator-Associated Pneumonia (VAP) is a major cause of mortality and morbidity despite recent advances in management owing to the looming 'antibiotic apocalypse'. The aetiology and susceptibility pattern of the VAP isolates varies with patient population, type of intensive care unit (ICU) and is an urgent diagnostic challenge. The present study carried out for a period of one year in a tertiary care hospital, enrolled patients on mechanical ventilation (MV) for ≥48 hrs. Endotracheal aspirates (ETA) from suspected VAP patients were processed by semi quantitative method. Staphylococus aureus, members of Enterobacteriaceae were more common in early onset VAP (EOVAP), while Nonfermenting Gram negative bacilli (NFGNB) were significantly associated with late onset VAP (LOVAP). Most of the isolates were multi drug resistant (MDR) super bugs. With limited treatment options left for this crisis situation like the pre-antibiotic era; it is an alarm for rational antibiotic therapy usage and intensive education programs.

Introduction Enterococci are recognized as opportunistic pathogens, as well as commensals in both humans and animals. They are an important cause of nosocomial infections, difficult to treat, as the organism have intrinsic and acquired resistance to many antibiotics. Aim To isolate and identify clinically relevant Enterococcus up to species level from all the clinical samples processed in the microbiology laboratory and also to study their resistance pattern. Materials and methods A prospective study was carried out for a period of one year from May 2014 to April 2015 at the Department of Microbiology, Subharti Medical College, Meerut, Uttar Pradesh, India. A total of 200 isolates of Enterococcus species from 15342 clinical samples obtained from IPD/OPD patients irrespective of age, having suspicion of bacterial infection were processed in the microbiology laboratory. Identification was done with standard biochemical methods. Antibiotic susceptibility testing was done on Muller Hilton agar plate by Kirby Bauer disc diffusion method. High-Level Gentamycin Resistance (HLGR) and High-Level Streptomycin Resistance (HLSR) were further confirmed by Agar dilution method and Broth microdilution method. Vancomycin and linezolid resistance was further confirmed by Agar dilution method and MIC was calculated by using VITEK 2, Biomerieux. All methodology was followed as per Clinical and Laboratory Standards Institute (CLSI) M100-S 24, 2014 guidelines. Results E. faecalis (n=169, 84.5%) was the predominant species isolated, followed by E. faecium (n=27, 13.5%) and E. casseliflavus (n=4, 2%). A total of 25 (12.5%) isolates were HLGR, 13 (6.5%) isolates were HLSR and 62 (31%) isolates were HLGR+HLSR. Vancomycin resistance was found in 14 (7%) isolates of which 11 (78.5%) were Van A and 3 (21.4%) were Van B, detected phenotypically as per relative MIC of vancomycin and teicoplanin. Linezolid resistance was seen in 4 (2%) of isolates which were vancomycin as well as high-level gentamycin and high-level streptomycin resistant. Conclusion Isolation of Enterococcus species resistant to most of the higher antibiotics like vancomycin and linezolid, with high prevalence of High-Level Aminoglycoside Resistance (HLAR), from hospitalized patients is a major concern as such isolates have limited or no therapeutic option.

Rapid susceptibility testing of Mycobacterium tuberculosis strains is imperative for therapy selection but traditional drug susceptibility tests take weeks or are expensive. Classical drug susceptibility (DST) may take up to 2 to 4 months. The line probe assay is a commercially available line-probe assay that rapidly detects Mycobacterium tuberculosis (MTB) complex, as well as the most common mutations associated with rifampicin and isoniazid. In this study we assessed the sensitivity and specificity of the rapid molecular method in comparison with the conventional method.

To find the incidence of human papillomavirus (HPV) infection and cervical intraepithelial neoplasia (CIN) in pregnant women and compare Pap smear with the HPV DNA test in detecting HPV infection.Hundred antenatal women, irrespective of gestational age, were enrolled as subjects in this prospective pilot study for blood investigations, wet mount examination of cervical discharge, Pap smear, and high-risk HPV DNA detection of cervical scrape by PCR. Women showing abnormality in Pap smear and/or those who were high-risk HPV DNA positive were subjected to colposcopy.The incidence of HPV-positive pregnant women was 18 %. Koilocytosis on Pap smear was observed in six women. Three high-risk HPV DNA-positive women showed changes consistent with CIN 1 on colposcopy.The HPV DNA test is the most sensitive and reliable in detecting HPV infection as compared to Pap smear, but considering the cost of PCR, Pap smear screening of all antenatal women was recommended.

Vancomycin-resistant Enterococci (VRE), especially Enterococcus faecium has emerged as an important nososcomial pathogen and represents a serious threat to patients with impaired host defense. Early detection of patients colonised or infected with VRE is an essential component of any hospital program designed to prevent nosocomial transmission of this organism. The authors report two cases of VRE isolated from blood and surgical site pus of two neonates admitted in the same neonatal unit, highlighting that early detection, prompt and appropriate infection control measures were keys to successful containment of this dreaded pathogen.

Introduction Bio-Medical Waste (BMW) management is of utmost importance as its improper management poses serious threat to health care workers, waste handlers, patients, care givers, community and finally the environment. Simultaneously, the health care providers should know the quantity of waste generated in their facility and try to reduce the waste generation in day-to-day work because lesser amount of BMW means a lesser burden on waste disposal work and cost saving. Aim To have an overview of management of BMW in a tertiary care teaching hospital so that effective interventions and implementations can be carried out for better outcome. Materials and methods The observational study was carried out over a period of five months from January 2016 to May 2016 in Chhatrapati Shivaji Subharti Hospital, Meerut by the Infection Control Team (ICT). Assessment of knowledge was carried out by asking set of questions individually and practice regarding awareness of BMW Management among the Health Care Personnel (HCP) was carried out by direct observation in the workplace. Further, the total BMW generated from the present setup in kilogram per bed per day was calculated by dividing the mean waste generated per day by the number of occupied beds. Results Segregation of BMW was being done at the site of generation in almost all the areas of the hospital in color coded polythene bags as per the hospital protocol. The different types of waste being collected were infectious solid waste in red bag, soiled infectious waste in yellow bag and sharp waste in puncture proof container and blue bag. Though awareness (knowledge) about segregation of BMW was seen in 90% of the HCP, 30%-35% did not practice. Out of the total waste generated (57912 kg.), 8686.8 kg. (15%) was infectious waste. Average infectious waste generated was 0.341 Kg per bed per day. The transport, treatment and disposal of each collected waste were outsourced and carried out by 'Synergy' waste management Pvt. Ltd. Conclusion The practice of BMW Management was lacking in 30-35% HCP which may lead to mixing of the 15% infectious waste with the remaining non-infectious. Therefore, training courses and awareness programs about BMW management will be carried out every month targeting smaller groups.

SummaryMucormycosis is a fungal infection commonly affecting structures in the head and neck, such as the air sinuses, orbits, and the brain. Common predisposing factors include diabetes mellitus and immunosuppression. We describe our clinical experience with four cases of mucormycosis of the maxillary antrum associated with uncontrolled diabetes mellitus managed at our centre. Early diagnosis and prompt treatment can significantly reduce the mortality and morbidity of this lethal fungal infection.

Patients who are immunocompromised are predisposed to a variety of common and uncommon pulmonary infections. We report a case of mixed pulmonary infection by drug resistant tuberculosis with a nocardiosis in a 49-year-old man who was a known case of chronic obstructive pulmonary disease, on prolonged corticosteroid use with diabetes mellitus. Chronic use of corticosteroids is a predisposing factor for opportunistic infections, such as nocardiosis or tuberculosis. Since such a mixed infection is rare, maybe a combined approach to therapy early in the course of disease would be effective in such cases.

Objective: Tuberculosis (TB) one of the most important major causes of mortality and morbidity around the world. Early detection of TB affords to prevent transmission of TB and better treatment options. The aim of this study is to evaluate sensitivity of fluorescent, Ziehl Neelsen microscopy and Polymerase Chain Reaction (PCR) method. Methods: Fifty samples of clinically suspected cases of pulmonary tuberculosis were collected and processed for Myco­bacteria by Fluorescent and ZN staining. Negative samples by staining methods were processed by PCR method using primer IS6110 of M. tuberculosis complex. Results: 33/50 (66.0%) samples were positive by Fluorescent and 23/50 (46%) were positive by ZN method. All micro­scopically negative samples (n=17) were processed to PCR and only seven of samples (41.1%) showed positive results. Conclusion: We concluded that PCR is best but it required lot of investment., Giriş: Tüberküloz dünyanın her yerinde hala önemli bir mortalite ve morbidite nedenidir. TB’nin erken tanınması daha iyi tedavi sonuçları ve MDR-TB’nin daha az bulaşmasını sağlar. Bu çalışmanın amacı flöresan boyama, Ziehl-Neelson mikroskobi ve PCR metotlarının duyarlılığını araştırmaktır.Yöntemler: Klinik olarak akciğer tüberküloz şüphesi olan vakalardan 50 örnek toplandı ve mikobakteriler için floresan ve ZN boyalarla değerlendirildi. Boyama metotları ile negatif olan örnekler M. tuberculosis complex IS6110 primeri kullanılarak PCR metodu ile değerlendirildi. Bulgular: Elli örnekten 33’ü (% 66,0) floresan ile ve 23’ü (% 46,0) ZN ile pozitifti. Mikroskobik olarak negative olan bütün örnekler (n=17) PCR ile çalışıldı ve sadece yedi örnek (% 41,1) pozitif bulundu. Sonuç: PCR en iyi metot olarak görülmektedir ancak ciddi altyapı yatırımı gerektirmektedir

Complexes of nickel(II), and copper(II) were synthesized with pantadentate ligand i.e. 3,3'-thiodipropionicacid-bis(5-amino-1,3,4-thiadiazole-2-thiol) (L). The ligand was synthesized by the condensation of thiodipropionic acid and 5-amino-1,3,4-thiadiazole-2-thiol in 1:2 ratio, respectively. Synthesized ligand was characterized by elemental analysis, mass, (1)H NMR, IR, and molecular modeling. All the complexes were characterized by elemental analysis, molar conductance, magnetic moment, IR, electronic spectra, ESR, and molecular modeling. The newly synthesized complexes possessed general composition [M(L)X2] where M = Ni(II), Cu(II), L = pantadentate ligand and X = Cl(-), CH3COO(-). The IR spectral data indicated that the ligand behaved as a pantadentate ligand and coordinated to the metal ion through N2S3 donor atoms. The molar conductance value of Ni(II), and Cu(II) complexes in DMSO corresponded to their electrolytic behavior. On the basis of spectral study, octahedral and tetragonal geometry was assigned for Ni(II) and Cu(II) complexes, respectively. In vitro fungicidal study of ligand and its complexes was investigated against fungi Candida albicans, Candida parapsilosis, Candidia krusei, and Candida tropicalis by means of well diffusion method.

Background: Vancomycin may be ineffective against an increasing proportion of methicillin resistant Staphylococcus aureus (MRSA) with minimum inhibitory concentrations (MICs) well within the susceptible range. On the other hand it is common knowledge that determination of vancomycin MICs is method dependent. Therefore, given the apparent variability in vancomycin MIC results obtained with the different methods, the use of the vancomycin MIC to predict the outcome of serious S. aureus infections needs to take into account the method used and the results of studies using that particular method. Aim: Comparative study was carried out to evaluate the MICs obtained by BMD method, E-test, and Vitek 2 method and to detect inconsistencies in these vancomycin for 66 MRSA isolates obtained from various samples of patients attending the OPDs & IPDs within a period of one year. Materials and Methods: A comparative study was carried out to evaluate the MICs obtained by BMD method, E-test, and Vitek 2 method to detect vancomycin susceptibility in 66 clinical isolates of MRSA obtained from various samples of patients attending the OPDs & IPDs within a period of one year. The study was conducted in Department of Microbiology, Subharti Medical College, Meerut from January to December 2012. Results: On determination of MICs for vancomycin for the MRSA isolates, all were identified as VSSA by BMD, E-Test & Vitek 2 methods. However, the vancomycin MIC values obtained by E-test correlated better with BMD method (correlation factor= 0.6727) than Vitek 2 (correlation factor=0.5316), indicating E-Test to be a better method for determination of vancomycin MICs as compared to Vitek 2. Conclusion: MRSA isolates with higher vancomycin MICs, even within the susceptibility range, are being observed more frequently which result in treatment failures with vancomycin. Because of the discrepancy that exists in vancomycin MIC results from different methods, the prediction of outcome of serious S.aureus infections should take into account the method used & results of studies using that particular method.

Aim: A population-based study was performed to detect the mutations in 81-bp rifampicin resistance determining region (RRDR) of rpoB gene in clinically isolated M. tuberculosis strains. Methods: Polymerase chain reaction (PCR) mediated direct DNA sequencing was used for rapid detection of rifampicin resistance of M. tuberculosis. Results: Among the 150 isolates, 115 were rifampicin sensitive and exhibited a wild-type pattern on PCR mediated direct sequencing, and remaining 35 isolates were found to be resistant. The codons most frequently involved in mutation were codon 531(40%), 526(23%), and 516(15%).Total twenty four kinds of mutation, which 18 point mutation, 4 insertion & 2 deletion were observed in 81-bp RRDR region of rpoB gene. Conclusion: The sequencing analysis for genotypic evaluation of rifampicin resistance is a highly sensitive assay and provides a practical alternative to in vitro testing in M. tuberculosis. Information on the profile of rpoB mutations in M. tuberculosis provides an improved diagnosis of rifampicin resistance by increasing the efficacy of gene sequencing based test.

Myiasis of different organs has been reported off and on from various regions in the world. We report a human case of intestinal myiasis caused by larvae of Sarcophaga. A 25 - year - old male presented with symptom of passage of live worms in stool. Following diagnosis and treatment the patient improved completely with cessation of maggots in stool.

Leprosy is a chronic inflammatory disease caused by Mycobacterium leprae, which affects not only the peripheral nerves and skin but also various internal viscera through the hematogenous spread, especially in lepromatous cases. The micropathological changes in epidermis, nerves and skin appendages from lesioned skin reported by various authors but reports of involvement of apparently normal sites are few. We investigated skin biopsy material taken from 130 patients with clinically diagnosed leprosy. Biopsies were taken at least 10 cm away from site of lesion. Hematoxylin and Eosin staining and Harada's modified Allochrome method for acid-fast bacilli were applied for histological investigations. The pattern of leprosy among the patients were indeterminate in 53 cases (40.8%), tuberculoid in 29 cases (22.3%), borderline tuberculoid in 14 cases (10.8%), borderline leprosy in ten cases (7.7%), borderline lepromatous in nine cases (6.9%) and lepromatous leprosy in 15 cases (11.5%). The changes were seen in sub-epidermal zone of normal appearing skin in all type of leprosy, but involvement was greater at the lepromatous end of the spectrum compared to tuberculoid end. Acid-fast bacillus (AFB) was seen in subepidermal zone of normal appearing site. Presence of AFB is significant as far as dissemination and transmission of disease is concerned.

Myiasis of different organs has been reported off and on from various regions in the world. We report a human case of external ophthalmomyiasis caused by the larvae of a sheep nasal botfly, Oestrus ovis, for the first time from Meerut city in Western Uttar Pradesh, India. A 25-year-old farmer presented with severe symptoms of conjunctivitis. The larvae, 3 in number, were observed in the bulbar conjunctiva, and following removal the symptoms of eye inflammation improved within a few hours.

Background and Objectives: Biofilms are colonies of microbial cells encased in a self-produced organic polymeric matrix. The biofilm production is more important for nonalbicans Candida (NAC); as C. albicans possess many other mechanisms to establish infections. Correct identification of Candida species has gained importance due to persistent rise in infections caused by NAC. We sought to isolate, identify Candida species in clinical isolates and study biofilm formation. Materials and Methods: Modified microtiter plate method was performed to study biofilm formation by isolates in Sabouraud's dextrose broth. It was then quantitatively assessed using a spectrophotometer. Biofilm formation was graded as negative, +1, +2, +3 and + 4 on the basis of percentage absorbance. Results: Biofilm formation was observed in 16 of 40 (40.0%) isolates of C. albicans as compared to 39 of 78 (50.0%) of isolates of NAC. Strong (+4) biofilm production was seen in maximum biofilm producers in C. tropicalis (12 of 27) followed by C. albicans (8 of 16). Total biofilm producers were significantly more among high vaginal swab isolates 63.2% (12 of 19) and urine isolates 59.2% (29 of 49), when compared to blood isolates 34.2% (13 of 38) as well as other isolates 27.5% (11 of 40). Interpretation and Conclusions: NAC species are qualitatively and quantitatively superior biofilm producers than C. albicans . Biofilm production is the most important virulence factor of NAC species and compared to other lesions, it is more significantly associated with luminal infections.

Aim: This study was performed for the rapid identification of Mycobacterium tuberculosis complex and its resistance to rifampicin and isoniazid, directly from the sputum samples of pulmonary tuberculosis patients. Materials and Methods: A commercially available genotype MTBDR plus assay was used for the identification and detection of mutations in Mycobacterial isolates. A total of 100 sputum samples of pulmonary tuberculosis patients were analyzed by using the genotype MTBDR plus assay. The MTBDR plus assay is designed to detect the mutations in the hotspot region of rpoB gene, katG and regulatory region of inhA gene. Results: The genotype MTBDR plus assay detected 22% multidrug resistant (MDR), 2% rifampicin (RMP) monoresistant and 1% isoniazid (INH) monoresistant isolates. In 22 MDR isolates, the codons most frequently involved in RMP-associated mutations were codon 531 (54.55%), 516 (31.82%) and 526 (13.63%), and 90.90% of MDR isolates showed KatG S315T mutations and 9.1% showed inhA C-15T mutations associated with INH resistance. Conclusion: The new genotype MTBDR plus assay represents a rapid, reliable tool for the detection of MDR-TB, wherein results are obtained in 5 h allowing early and appropriate treatment, which is essential to cut the transmission path and reduce the spread of MDR-TB. The genotype MTBDR plus assay can readily be included in a routine laboratory work for the early diagnosis and control of MDR-TB.

Conventional methods for detection of Mycobacterium tuberculosis from culture can take up to 8 weeks. Simple and sensitive methods that enhance the detection of Mycobacterium tuberculosis (M.tuberculosis) from clinical specimens are needed, to achieve early diagnosis and effective treatment of pulmonary tuberculosis. To facilitate the rapid detection of Mycobacterium tuberculosis complex and its drug sensitivity pattern by line probe assay was performed in our study.

Aim: The purpose of this in vitro study was to determine whether the addition of 2% chlorhexidine gluconate or 10% doxycycline would enhance the antimicrobial activity of Biodentine against Staphylococcus aureus (ATCC-25923), Enterococcus faecalis (ATCC-29212), Candida albicans (ATCC-90028), and Streptococcus mutans (MTCC-497). Materials and Methods: Three wells of 4 mm diameter and 4 mm depth on each plate were prepared on the agar medium with standardized suspensions of each microorganism. Biodentine powder mixed with 2% chlorhexidine (0.06 g) or 10% doxycycline (0.30 g) in its liquid or liquid alone was placed to fill each well. Plates were incubated at 37°C as required for microbial growth. A blinded, independent observer measured zones of inhibition. The data were analyzed using independent t test to compare the differences among the three cement preparations for different micro-organisms. Results: All Biodentine samples inhibited microbial growth. The highest mean diameters of zone of inhibition for all the micro-organisms were found around Biodentine/chlorhexidine (13.417) followed by Biodentine alone (12.236) and Biodentine/doxycycline (11.25). Conclusion: In conclusion, adding 2% chlorhexidine gluconate in liquid of Biodentine enhanced the antimicrobial activity of Biodentine against all the tested micro-organisms except Candida albicans, while addition of 10% doxycycline decreased the antimicrobial activity of Biodentine. The differences were significant statistically (P < 0.05).

Owing to the paucity of information on vancomycin resistance in enterococci from India, in the present study, enterococci isolated from urine specimen were studied for there antibiotic susceptibility & screened for vancomycin resistance.

Over the last 30 years Helicobacter pylori has proved to be of overwhelming importance in the etiology of a number of common gastroduodenal diseases, like chronic gastritis, peptic ulceration and gastric cancer(1). This study was undertaken to see the association of Helicobacter pylori in cases of Peptic ulcer disease and to study the diagnostic yield of various standard conventional methods and serological test for Helicobacter pylori.

Epidemiology of HIV-AIDS in an area especially with regards to socio-demographic factors helps in choosing and implementing a particular intervention in much better way. Study included counseling and testing of clients that were either self initiated or referred from the hospital over a period of 2 years. Analysis of ICTC data of all positive attendees was done. HIV positivity rate was 1% with male to female ratio of 2.2:1. Majority of positive males were literate and belonged to service class whereas most of the positive females were housewives. Spillage of the epidemic on to general population might well cause significant alteration in trends noted till times.

in a child, acase not reported earlier to our knowledge.A previously healthy 5-year-old boy with varicellainfection presented seven days later to our emergencydepartment with high grade fever, productive cough,dyspnoea and mild swelling of left side of chest. Onadmission, he had signs of respiratory distress, poorperfusion and severe dehydration. He was pale anddyspnoeic, with a temperature of 41.2°C.The PaO

Background: Nosocomial infections are on the rise worldwide and many a times they are carried by the health care personnel. Accessories used by physicians and healthcare personnel can be a potential source of nosocomial infection. Materials and Methods: We designed a survey with the aim to investigate the prevalence of microbial flora of accessories such as pens, stethoscopes, cell phones and white coat used by the physicians working in a tertiary care hospital. Observations: It was observed that 66% of the pens, 55% of the stethoscopes, 47.61% of the cell phones and 28.46% of the white coats used by the doctors were colonized with various microorganisms. Staphylococcus spp. was the predominant isolate followed by Escherichia coli. Methicillin resistance in Staphylococcus aureus was also found, which was a matter of concern. Conclusions: Awareness of appropriate hand hygiene is important in order to prevent potential transmission to patients.