have been studied. Although, PCR is highly accurate and sensitive test for MBL detection and track their clonal spread, utility is limited by its Lapatinib structure high cost. Surveillance for the presence and dissemination of this highly epidemic clone needs to be investigated further, if possible with molecular methods of typing. Molecular typing illustrated the ease with which MBL-producing strains accompanied patients when transferred to other acute care centers, nursing homes or the community. However, these strains did not cause an outbreak outside acute care center, underlining yet again the importance of environmental reservoirs as a cause of nosocomial outbreaks due to MBL producing P. aeruginosa.[11,14] Awareness of entry of MBL-producing isolates into a hospital environment is the first Inhibitors,Modulators,Libraries step that clinical microbiologists can take to address this problem.

Outbreak was contained with strict isolation practices and the replacement of faucets at both the units.[14] Moreover, no further analyses have been performed to establish carriers�� contribution to increasing nosocomial infections due to IR-MBLP isolates at our hospital. Inhibitors,Modulators,Libraries Timely identification of increased isolations of this pathogen, achieved by active surveillance, appears to be crucial to limit the spreading of IR-MBLP isolates in our hospital. LIMITATIONS OF THE PRESENT STUDY Carrier state and role of the carriers in nosocomial infections due to IR-MBLP-PA could not be assessed with certainty. Whether isolation of IR-MBLP-PA from HCWs represents transient colonization or carrier state was not assessed beyond doubt.

Inhibitors,Modulators,Libraries Role of carrier state as a cause of (acting as source and/or reservoir of infection) nosocomial infections due to IR-MBLP-PA isolate in ICUs could not be assessed with certainty. IR-MBLP-PA carrier state among HCWs could have been the effect of frequent contact of HCWs with patients suffering from IR-MBLP-PA Inhibitors,Modulators,Libraries nosocomial infections. Possibility of acquisition of IR-MBLP-PA from patients could not be ruled out in the present study. CONCLUSIONS OF THE STUDY Role of IR-MBLP-PA carriers among HCWs as a source Inhibitors,Modulators,Libraries and/or reservoirs of IR-MBLP-PA nosocomial infections is doubtful, but possibility cannot be ruled out Role of IR-MBLP-PA carrier during outbreaks cannot be ruled out thus necessitating targeted surveillance of HCWs for IR-MBLP-PA carrier state in high risk areas of the hospital and practicing strict infection control measures Dacomitinib especially hand hygiene. Further research is needed to explore other sources and/or reservoirs of IR-MBLP-PA by molecular methods namely, environmental sources and colonized patients ACKNOWLEDGMENT We duly acknowledge the statistical analysis done by Mrs. Rajashree Patil, Asst. Prof. and Statistician, Dept. of Community Medicine, SSIMS and RC, Davanagere.