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  1. Article ; Online: Antibiotic Susceptibility and Biofilm Production among Coagulase Negative Staphylococci Isolated from Clinical Samples at Tertiary Care Hospital.

    Shah, Pradeep Kumar / Bhandari, Niru / Tamang, Basanta / Joshi, Rajendra D

    Journal of Nepal Health Research Council

    2024  Volume 21, Issue 4, Page(s) 636–641

    Abstract: Background: Coagulase Negative Staphylococci have been widely associated with medical device implant treatment and immune-compromised patients. Despite having increasing interest in Coagulase Negative Staphylococci, few studies from Nepal have reported ... ...

    Abstract Background: Coagulase Negative Staphylococci have been widely associated with medical device implant treatment and immune-compromised patients. Despite having increasing interest in Coagulase Negative Staphylococci, few studies from Nepal have reported the association of these organisms with urinary tract infections, conjunctivitis, high vaginal swabs, and cerebrospinal fluid. This study was carried out to determine antibiotic susceptibility pattern and biofilm production among Coagulase Negative Staphylococci isolated from clinical samples at tertiary care hospital.
    Methods: This study was a hospital based cross-sectional study in which 3690 clinical samples were included. Isolation and identification of isolates was done following standard microbiological protocol. Coagulase Negative Staphylococci were identified phenotypically on the basis of gram staining, slide and tube coagulase test and by various sugar fermentation tests. Antibiotic susceptibility test was done following Kirby Bauer disk diffusion method (Clinical and Laboratory Standards Institute 2020). Biofilm production was determined by Tissue Culture Plate technique.
    Results: A total of 113 isolates of Coagulase Negative Staphylococci were detected. Among them S. epidermidis (45.1%), S. saprophyticus (23.9%), S. haemolyticus (16.8%), S. hominis (5.3%), S. capitis (2.7%), -----S. cohini (1.8%), S. lugdunensis (1.8%) and S. sciuri (2.7%) were identified phenotypically. All isolates were found to be resistant against Ampicillin and 111 (98.2%) were sensitive against Linezolid.23.9% of CoNS were strong biofilm producers, 19.5% moderate and 56.6 % were non/weak biofilm producers.
    Conclusions: It requires susceptibility test for prescribing antibiotics against Coagulase Negative Staphylococci in hospital and the misuse of antibiotics should be prevented.
    MeSH term(s) Female ; Humans ; Coagulase ; Cross-Sectional Studies ; Tertiary Care Centers ; Nepal ; Staphylococcus ; Anti-Bacterial Agents/pharmacology ; Biofilms
    Chemical Substances Coagulase ; Anti-Bacterial Agents
    Language English
    Publishing date 2024-03-31
    Publishing country Nepal
    Document type Journal Article
    ZDB-ID 2551251-1
    ISSN 1999-6217 ; 1999-6217
    ISSN (online) 1999-6217
    ISSN 1999-6217
    DOI 10.33314/jnhrc.v21i4.4894
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Higher Rate of Extreme Drug-resistant Klebsiella pneumoniae Infections among Cardiac Patients.

    Paudel, Subash / Shah, Pradeep Kumar / Adhikari, Prashanna / Singh K C, Sanjay / Thapa Shrestha, Upendra

    Journal of Nepal Health Research Council

    2022  Volume 19, Issue 4, Page(s) 661–668

    Abstract: Background: The accelerating rate of carbapenems resistance in Klebseilla pneumoniae isolates has put the treatment option worrisome. The effective strategy to ameliorate this alarming situation is possible through enhancing the combination therapy and ... ...

    Abstract Background: The accelerating rate of carbapenems resistance in Klebseilla pneumoniae isolates has put the treatment option worrisome. The effective strategy to ameliorate this alarming situation is possible through enhancing the combination therapy and appropriate laboratory diagnosis. Hence, the study was focused on identifying carbapenemase-producing K. pneumoniae and their antibiogram pattern.
    Methods: A total of 944 clinical samples from patients attending Sahid Gangalal National Heart Center were processed from September 2019 to March 2020 to identify the possible bacterial pathogens following the standard microbiological procedures. K. pneumonaie isolates were further subjected to antibiotic susceptibility testing by the modified Kirby Bauer disc diffusion technique. Phenotypic confirmation of carbapenemase production was done by the modified carbapenemase inactivation method. The minimum inhibitory concentration of colistin was determined by the broth microdilution method.
    Results: Of the total 944 samples, 15.47% (146) samples showed bacterial growth, among which 23.97% (35) were K. pneumoniae. Out of 35 K. pneumoniae isolates, 45.71% (16) were multidrug-resistant followed by 42.86% (15) extensively drug-resistant. Fourteen isolates of K. pneumoniae were carbapenemase producers among which 20% (7) were serine carbapenemase while 20% (7) showed metallo-?-lactamase production. All the carbapenemase-producing K. pneumoniae were susceptible to colistin with <0.125µg/ml. Carbapenemase activity showed statistically significant with multidrug resistance (p=<0.05).
    Conclusions: An increasing resistance to the carbapenem drugs showed a great problem in the management of K. pneumoniae infections among immunocompromised patients especially cardiac patients however, colistin can be still an ultimate choice of drug for disease management.
    MeSH term(s) Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Carbapenems/pharmacology ; Carbapenems/therapeutic use ; Colistin/pharmacology ; Humans ; Klebsiella Infections/drug therapy ; Klebsiella Infections/microbiology ; Klebsiella pneumoniae ; Microbial Sensitivity Tests ; Nepal ; beta-Lactamases
    Chemical Substances Anti-Bacterial Agents ; Carbapenems ; beta-Lactamases (EC 3.5.2.6) ; Colistin (Z67X93HJG1)
    Language English
    Publishing date 2022-03-13
    Publishing country Nepal
    Document type Journal Article
    ZDB-ID 2551251-1
    ISSN 1999-6217 ; 1999-6217
    ISSN (online) 1999-6217
    ISSN 1999-6217
    DOI 10.33314/jnhrc.v19i04.3524
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: gyrA ser83 mutation among fluoroquinolone-resistant Salmonella enterica serovars from enteric fever patients in tertiary care hospital, Kathmandu.

    Adhikari, Prashanna / Maharjan, Roshani / Paudel, Subash / Malla, Bikram / Shah, Pradeep Kumar / Bastola, Anup / Shrestha, Upendra Thapa

    BMC microbiology

    2022  Volume 22, Issue 1, Page(s) 51

    Abstract: Background: The management of enteric fever through antibiotics is difficult these days due to the emerging resistance of Salmonella to various antimicrobial agents. The development of antimicrobial resistance is associated with multiple factors ... ...

    Abstract Background: The management of enteric fever through antibiotics is difficult these days due to the emerging resistance of Salmonella to various antimicrobial agents. The development of antimicrobial resistance is associated with multiple factors including mutations in the specific genes. To know the current status of mutation-mediated fluoroquinolone-resistance among Salmonella enterica serovars; Typhi, Paratyphi A, B and C, this study was focused on detecting gyrA ser83 mutation by restriction digestion analysis of gyrA gene using HinfI endonuclease.
    Results: A total of 948 blood samples were processed for isolation of Salmonella spp. and 3.4% of them were found to be positive for Salmonella growth. Out of the 32 Salmonella isolates, 2.2% were S. Typhi and 1.2% were S. Paratyphi A. More interestingly, we observed less than 5% of isolates were resistant to first-line drugs including chloramphenicol, cotrimoxazole and ampicillin. More than 80% of isolates were resistant to fluoroquinolones accounting for 84.4% to levofloxacin followed by 87.5% to ofloxacin and 100% to ciprofloxacin by disc diffusion methods. However, the minimum inhibitory concentration method using agar dilution showed only 50% of isolates were resistant to ciprofloxacin. A total of 3.1% of isolates were multidrug-resistant. Similarly, 90.6% of the Salmonella isolates showed gyrA ser83 mutation with resistance to nalidixic acid.
    Conclusions: The increased resistance to fluoroquinolones and nalidixic acid in Salmonella isolates in our study suggests the use of alternative drugs as empirical treatment. Rather, the treatment should focus on prescribing first-line antibiotics since we observed less than 5% of Salmonella isolates were resistant to these drugs.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents/pharmacology ; Child ; Child, Preschool ; Cross-Sectional Studies ; DNA Gyrase/genetics ; Drug Resistance, Bacterial/genetics ; Female ; Fluoroquinolones/pharmacology ; Humans ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Mutation ; Salmonella enterica/drug effects ; Salmonella enterica/genetics ; Serogroup ; Tertiary Care Centers/statistics & numerical data ; Typhoid Fever/blood ; Typhoid Fever/epidemiology ; Typhoid Fever/microbiology ; Young Adult
    Chemical Substances Anti-Bacterial Agents ; Fluoroquinolones ; DNA Gyrase (EC 5.99.1.3)
    Language English
    Publishing date 2022-02-10
    Publishing country England
    Document type Journal Article
    ZDB-ID 2041505-9
    ISSN 1471-2180 ; 1471-2180
    ISSN (online) 1471-2180
    ISSN 1471-2180
    DOI 10.1186/s12866-022-02456-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Bacteriological Study of Otitis Media and Its Antibiotic Susceptibility Pattern.

    Basnet, Rabina / Sharma, Sudarshan / Rana, Jid Chani / Shah, Pradeep Kumar

    Journal of Nepal Health Research Council

    2017  Volume 15, Issue 2, Page(s) 124–129

    Abstract: Background: Otitis Media is a prevailing and notorious infection in developing countries causing serious local damage and threating complication. Mainly in developing countries like Nepal, Otitis Media results because of illiteracy, poverty and poor ... ...

    Abstract Background: Otitis Media is a prevailing and notorious infection in developing countries causing serious local damage and threating complication. Mainly in developing countries like Nepal, Otitis Media results because of illiteracy, poverty and poor hygiene. The aim of this study was to determine the profile of Otitis Media, its causative agents and their antibiotic susceptibility pattern.
    Methods: The study included 263 pus samples from 240 patients attending ENT department of Bharatpur hospital from May 2015 to January 2016. Samples were processed in microbiology department for bacteria using standard operating protocol. Antibiotic susceptibility testing was performed for all bacterial isolates by Kirby Bauer disc diffusion method and the results were interpreted according to clinical and laboratory standard institute (CLSI) guideline.
    Results: Out of 240 patients, 121 were female and 119 were male. Highest incidence of Otitis Media was observed in 1-10 year age group. Out of 263 samples taken from 240 patients, 216 showed bacterial growth. Gram negative bacteria predominated and the most common bacteria isolated were Staphylococcus aureus 36.11% followed by Pseudomonas aeruginosa 33.33% and Coagulase Negative Staphylococci 8.08%. All bacterial isolates were sensitive to gentamycin. Staphylococcus aureus was sensitive to Amikacin and gentamycin. All gram negative bacterial isolates were sensitive to Imipenem and gentamycin. 100% of Pseudomonas aeruginosa was sensitive to Imipenem.
    Conclusions: Staphylococcus aureus was the most predominant organism isolated from the pus swab followed by Pseudomonas aeruginosa and all the isolated organisms were sensitive to Gentamycin.
    MeSH term(s) Adolescent ; Adult ; Anti-Bacterial Agents/pharmacology ; Child ; Child, Preschool ; Disk Diffusion Antimicrobial Tests ; Drug Resistance, Bacterial ; Female ; Gram-Negative Bacteria/isolation & purification ; Humans ; Infant ; Male ; Middle Aged ; Nepal ; Otitis Media/microbiology ; Pseudomonas aeruginosa/isolation & purification ; Staphylococcus aureus/isolation & purification ; Young Adult
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2017-09-08
    Publishing country Nepal
    Document type Journal Article
    ZDB-ID 2551251-1
    ISSN 1999-6217 ; 1727-5482
    ISSN (online) 1999-6217
    ISSN 1727-5482
    DOI 10.3126/jnhrc.v15i2.18186
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Surgical Site Infections and Antimicrobial Resistance Pattern.

    Chaudhary, Raskin / Thapa, Shrawan Kumar / Rana, Jid Chani / Shah, Pradeep Kumar

    Journal of Nepal Health Research Council

    2017  Volume 15, Issue 2, Page(s) 120–123

    Abstract: Background: Post-operative surgical site infections (SSIs) are among the leading cause of morbidity and increased medical expense. The aim of this study is to isolate identify and study antimicrobial susceptibility pattern of microorganism from surgical ...

    Abstract Background: Post-operative surgical site infections (SSIs) are among the leading cause of morbidity and increased medical expense. The aim of this study is to isolate identify and study antimicrobial susceptibility pattern of microorganism from surgical wound of admitted patients.
    Methods: This retrospective study was carried at the Microbiology Laboratory of Bharatpur hospital, Nepal, from May 2015 to October 2015. The pus samples were cultured and antibiotic susceptibility determined in vitro by Kirby Bauer's disc diffusion method following clinical and Laboratory Standards Institute (CLSI) 2014 recommendation.
    Results: Of the total 250 samples, 194 (77.6%) showed bacterial growth. Staphylococcus aureus was 47.4% and Escherichia coli 20.60 %. Of 194 isolates 39.2% were multi drug resistant. Amikacin was sensitive in 93.1% of Gram positive isolates and 81.8% of gram negative isolates.
    Conclusions: Bacterial growth is common in surgical site. Staphylococcus aureus and Escherichia coli were multidrug resistant. Grampositive and gram negative isolates were commonly sensitive to Amikacin.
    MeSH term(s) Adolescent ; Adult ; Amikacin/pharmacology ; Anti-Bacterial Agents/pharmacology ; Cross-Sectional Studies ; Disk Diffusion Antimicrobial Tests ; Drug Resistance, Bacterial ; Drug Resistance, Multiple, Bacterial ; Escherichia coli/drug effects ; Escherichia coli/isolation & purification ; Female ; Humans ; Male ; Middle Aged ; Nepal ; Retrospective Studies ; Staphylococcus aureus/drug effects ; Staphylococcus aureus/isolation & purification ; Surgical Wound Infection/microbiology ; Young Adult
    Chemical Substances Anti-Bacterial Agents ; Amikacin (84319SGC3C)
    Language English
    Publishing date 2017-09-08
    Publishing country Nepal
    Document type Journal Article
    ZDB-ID 2551251-1
    ISSN 1999-6217 ; 1727-5482
    ISSN (online) 1999-6217
    ISSN 1727-5482
    DOI 10.3126/jnhrc.v15i2.18185
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Comparison of Nasal Colonization of Methicillin-Resistant

    Neupane, Kalash / Rayamajhee, Binod / Acharya, Jyoti / Rijal, Nisha / Shrestha, Dipendra / G C, Binod / Pant, Mahesh Raj / Shah, Pradeep Kumar

    The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale

    2018  Volume 2018, Page(s) 4508757

    Abstract: Background: Staphylococcus aureus: Methods: This study was conducted from June 2016 to December 2016 at National Public Health Laboratory (NPHL), Kathmandu, with an aim to assess the rate of : Results: Overall, out of 600 nasal swabs of patients ... ...

    Abstract Background: Staphylococcus aureus
    Methods: This study was conducted from June 2016 to December 2016 at National Public Health Laboratory (NPHL), Kathmandu, with an aim to assess the rate of
    Results: Overall, out of 600 nasal swabs of patients tested, 125 (20.8%) were
    Conclusion: Regular surveillance and monitoring of MRSA nasal carriage and antibiotic susceptibility pattern are of prime importance in controlling
    Language English
    Publishing date 2018-12-04
    Publishing country Egypt
    Document type Journal Article
    ZDB-ID 1057056-1
    ISSN 1712-9532 ; 1180-2332
    ISSN 1712-9532 ; 1180-2332
    DOI 10.1155/2018/4508757
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  7. Article ; Online: Co-existence of beta-lactamases in clinical isolates of Escherichia coli from Kathmandu, Nepal.

    Pokhrel, Ram Hari / Thapa, Badri / Kafle, Rajesh / Shah, Pradeep Kumar / Tribuddharat, Chanwit

    BMC research notes

    2014  Volume 7, Page(s) 694

    Abstract: Background: The trend of extended-spectrum beta-lactamases producing Escherichia coli (ESBL-EC) is increasing in Nepal. Limited studies have been reported investigating ESBL types and carbapenemases in E. coli.: Methods: A cross sectional study was ... ...

    Abstract Background: The trend of extended-spectrum beta-lactamases producing Escherichia coli (ESBL-EC) is increasing in Nepal. Limited studies have been reported investigating ESBL types and carbapenemases in E. coli.
    Methods: A cross sectional study was conducted between June 2012 to January 2013 in Kathmandu Medical College and Teaching Hospital, Nepal. Non-repetitive clinical samples from out-patient department (OPD) and Intensive Care Units (ICU) were processed for bacteriological culture and identification of E. coli. Antibiotic susceptibility test, screening and phenotypic confirmation for ESBLs and carbapenemases and PCR (blaCTX-M, blaSHV and blaTEM-type ESBLs, blaVIM, blaIMP and blaNDM-1-type carbapenemases, and class 1 integron element integrase gene) were performed. Clones were resolved by PCR-Randomly Amplified Polymorphic DNA.
    Results: Out of 332 non-repetitive clinical specimens processed for culture and identification 160 (48.2%) were culture positive. Of which, 93 (58.1%) were E. coli. Of these, 24 (25.8%) were phenotypically confirmed as ESBL-EC and 3 (12.50%) of 24 ESBL-EC were carbapenemase producers. blaCTX-M-type ESBL was most common (23, 95.8%) followed by blaTEM (7, 29.2%) and blaSHV (3, 12.5%). blaVIM, blaIMP and blaNDM-1 were present in 3, 2 and 2 ESBL-EC, respectively. Class 1 integron element was present in 18 (75.0%) ESBL-EC. Nine isolates possessed more than one type of beta-lactamases. Interestingly, all carbapenemase producers were isolated form ICU and co-existence of blaCTX-M, blaSHV, blaTEM, blaIMP, blaVIM and blaNDM-1 beta-lactamases was documented in one ESBL-EC (EC104). All most all isolates had different RAPD patterns.
    Conclusions: For the first time in Nepal, high prevalence of blaCTX-M-type ESBL and co-existence of ESBLs and carbapenemases has been described. Continuous monitoring and surveillance and proper infection control and prevention practices will limit the further spread of these super-bugs within this hospital and beyond.
    MeSH term(s) Anti-Bacterial Agents/therapeutic use ; Bacterial Proteins/isolation & purification ; Cross-Sectional Studies ; DNA, Bacterial/isolation & purification ; Drug Resistance, Bacterial ; Escherichia coli/drug effects ; Escherichia coli/enzymology ; Escherichia coli/genetics ; Escherichia coli/isolation & purification ; Escherichia coli Infections/diagnosis ; Escherichia coli Infections/drug therapy ; Escherichia coli Infections/epidemiology ; Escherichia coli Infections/microbiology ; Escherichia coli Proteins/genetics ; Escherichia coli Proteins/isolation & purification ; Genotype ; Hospitals, Teaching ; Humans ; Microbial Sensitivity Tests ; Nepal/epidemiology ; beta-Lactamases/genetics ; beta-Lactamases/isolation & purification
    Chemical Substances Anti-Bacterial Agents ; Bacterial Proteins ; DNA, Bacterial ; Escherichia coli Proteins ; beta-Lactamases (EC 3.5.2.6) ; carbapenemase (EC 3.5.2.6)
    Language English
    Publishing date 2014-10-07
    Publishing country England
    Document type Journal Article
    ZDB-ID 2413336-X
    ISSN 1756-0500 ; 1756-0500
    ISSN (online) 1756-0500
    ISSN 1756-0500
    DOI 10.1186/1756-0500-7-694
    Database MEDical Literature Analysis and Retrieval System OnLINE

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