**7. Multidrug resistant organisms and infection control practices**

The multidrug resistant organisms are prevalent in Health care set up now a days because of overuse and misuse of antimicrobials. The empirical use of antimicrobials in health care set up has to be stopped and must be guided by antibiotic sensitivity test with proper dosage schedule.

In every health care set up, an antimicrobial use committee should be there, which establishes prescribing policies, audits antibiotic use etc. Antimicrobial use committee may be a subcom‐ mittee of HICC or an independent committee working hands in hands with HICC.

Transmission of MRSA, Vancomycin Resistant Enterococci (VRE) occurs through hands of HCWs, hence, transfer of staffs and patients should be reduced. Early detection of cases and placing MRSA/VRE/MDRO infected patients in a single room or in a large ward putting all MRSA infected patients (cohorting). The operating surgeons should not do surgeries until declared negative for carriage of MRSA / MDRO. Early detection of the organism and measures for managing any outbreak especially in nurseries and postopera‐ tive wards should be planned.

The same strategy has to be adopted for ESBL, AmpC β – lactamase and MBL producing Gram negative organisms.

All HCWs and patient's visitors strictly follow standard and contact precautions.
