RK Dahal

Tribhuvan University Teaching Hospital

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JB Sherchand

Nepal Medical College Teaching Hospital

NR Banjade

Tribhuvan University Teaching Hospital

HP Kattel

Tribhuvan University Teaching Hospital

Srijana Karmacharya

Nepal Medical College Teaching Hospital

BP Rijal

Tribhuvan University Teaching Hospital

BM Pokhrel

Tribhuvan University Teaching Hospital

SK Mishra

Tribhuvan University Teaching Hospital

Sarita Shrestha

Örebro University

SK Mishra

B.P. Koirala Institute of Health Sciences

Ranjit Kumar Chaudhary

Nepalese Army Institute of Health Services

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Tribhuvan University Teaching Hospital

Tribhuvan University

Nepal Medical College Teaching Hospital

National Center for Global Health and Medicine

Juntendo University

Nepalese Army Institute of Health Services

All India Institute of Medical Sciences

Patan Academy of Health Sciences

Infectious Disease Research Institute

National Institute of Infectious Diseases

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Incidence of Bacteremia and Septicemia in patients attending in tertiary care center, Nepal

Journal of Institute of Medicine Nepal (2012)

Rahul Choudhary Srijana Karmacharya Sarita Shrestha RK Dahal SK Mishra

Introduction: Bacteremia and septicemia is life threatening condition resulting in major cause of mortality and morbidity. The aim of study was to determine the etiology of bacteremia and septicemia with antibiotic sensitivity profile of those organisms. Methods: A prospective study was carried out among the suspected cases from both inpatient and outpatient of TUTH from October 2009 - March 2010. Blood samples were collected and processed according to standard methodology. Results: Out of 2259 samples only 237 (10.49 %) showed bacterial growth. The most common isolates among Salmonella group was Salmonella enterica serotype typhi 71(29.95%) followed by Salmonella enterica serotype Paratyphi A 45 (18.98%). Among non Salmonella group Pseudomonas aeruginosa 34 (14.34%), Klebsiella pneumoniae 22(9.28%), Acinetobacter spp 15 (6.32%), Citrobacter spp 5 (2.10%), Escherichia coli 3 (1.26%) while Staphylococcus aureus 34 (14.3%) was most common followed by Enterococcus spp 3 (1.26%), Streptococcus spp 2 (0.84%), Coagulase Negative Staphylococcus 2 (0.84%) and Listeria spp 1 (0.42%) among Gram Positive organisms. Antibiogram revealed Cefotaxime, Ceftazidime, Azithromycin and Chloramphenicol for Salmonella group while for non Salmonella Imipenem, Meropenem and Amikacin as most effective antibiotics while Clindamycin, Ciprofloxacin and Ofloxacin for gram positive. Conclusion: Gram negative bacteria was the predominant organism causing bacteremia and septicemia. Among them salmonella typhi and salmonella paratyphi were the leading aetiology.

Tertiary care

Bacteremia

Center (category theory)

10.59779/jiomnepal.474

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Incidence of Bacteremia and Septicemia in patients attending in tertiary care center, Nepal

Journal of Institute of Medicine Nepal (2013)

Ranjit Kumar Chaudhary Srijana Karmacharya Sushan Man Shrestha RK Dahal SK Mishra

Introduction: Bacteremia and septicemia is life threatening condition resulting in major cause of mortality and morbidity.The aim of study was to determine the etiology of bacteremia and septicemia with antibiotic sensitivity profile of those organisms. Methods: A prospective study was carried out among the suspected cases from both inpatient and outpatient of TUTH from October 2009 .March 2010. Blood samples were collected and processed according to standard methodology. Results: Out of 2259 samples only 237 (10.49 %) showed bacterial growth. The most common isolates among Salmonella group was Salmonella enterica serotype typhi 71(29.95%) followed by Salmonella enterica serotype Paratyphi A 45(18.98%). Among non Salmonella group Pseudomonas aeruginosa 34(14.34%), Klebsiella pneumoniae 22(9.28%), Acinetobacter spp 15 (6.32%), Citrobacter spp 5(2.10%), Escherichia coli 3(1.26%) while Staphylococcus aureus 34 (14.3%) was most common followed by Enterococcus spp 3(1.26%), Streptococcus spp 2(0.84%), Coagulase Negative Staphylococcus 2(0.84%) and Listeria spp 1(0.42%) among Gram Positive organisms. Antibiogram revealed Cefotaxime, Ceftazidime, Azithromycin and Chloramphenicol for Salmonella group while for non Salmonella Imipenem, Meropenem and Amikacin as most effective antibiotics while Clindamycin, Cipro!oxacin and O!oxacin for gram positive. Conclusion: Gram negative bacteria was the predominant organism causing bacteremia and septicemia. Among them salmonella typhi and salmonella paratyphi were the leading aetiology. DOI: http://dx.doi.org/10.3126/joim.v34i3.8915 Journal of Institute of Medicine, December, 2012; 34:32-38

Bacteremia

Salmonella enterica

10.3126/jiom.v34i3.8915

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Ventilator Associated Pneumonia in Tertiary Care Hospital, Maharajgunj, Kathmandu, Nepal

Journal of Institute of Medicine Nepal (2024)

RK Shrestha RK Dahal SK Mishra K Parajuli BP Rijal

Introduction: Ventilator Associated Pneumonia (VAP) is the most common nosocomial infection among intensive care unit (ICU) patients and lack of much information in Nepal. So, the aim of this study was to determine prevalence and bacteriological profile of VAP with special reference to multi-drug resistant (MDR), Methicillin-resistant Staphylococcus aureus(MRSA), Metallo-β-Lactamase(MBL), Extended-Spectrum β-Lactamase(ESBL)-producing bacterial strains. Methods: A total 150 tracheal specimens were studied during June 2011 to May 2012 at Department of Microbiology, TUTH as described by American Society for Microbiology (ASM). Combination disk method was done for the detection of ESBL and MBL producing isolates. Results: Prevalence of VAP was found to be 34%. Acinetobactereal coaccticusbaumannii complex (44%) was the commonest isolate, followed by Klebsiellapneumoniae (22%), Pseudomonas aeruginosa (16%) and Staphylococcus aureus (12%). Among MDR Gram negative bacteria (GNB), 39% were MBL and 33% were ESBL-producers. All GNB (61) were sensitive to Polymyxin B and Colistinsulphate, whereas, 48% were found resistant to Carbapenems. Prevalence of MRSA was 75%, which were all sensitive to Vancomycin. Conclusion: High prevalence of VAP, MDR along with MRSA or ESBL or MBL producing strains was found in the study. Thus, suitable control measures must be adopted to cope up this alarming situation with genetic characterization.

Ventilator-associated Pneumonia

Polymyxin

10.59779/jiomnepal.626

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Prevalence of nosocomial lower respiratory tract infections caused by Multi- drug resistance pathologens

Journal of Institute of Medicine Nepal (2011)

Sarita Shrestha Rahul Chaudhari Srijana Karmacharya HP Kattel SK Mishra

Introduction: Nosocomial infections caused by multi-drug resistant pathogens are major threat to the hospitalized patients. Extended spectrum beta-lactamase (ESBL) and metallo-beta-lactamase (MBL) producing bacterial strains causing hospital acquired lower respiratory tract infection are increasing in numbers. Only a limited number of studies related to MBL producers have been done in Nepal. Objective: The goal of this study was to determine the etiology of nosocomial lower respiratory tract infections and to assess the current levels of antimicrobial resistance with special reference to ESBL and MBL producing bacterial strains. Methods: A total of 100 specimens including sputum and endotracheal secretion from patients diagnosed of nosocomial lower respiratory tract infection were collected and processed according to the standard methodology. Combination disk method was done for the detection of ESBL and MBL producing isolates. Results: Out of total 100 specimens, 87% was monomicrobial while the rest were polymicrobial. 96.5 % were gram negative while 3.5% were gram positive. All E.coli, Klebsiella spp and S. aureus were found to be MDR followed by Acinetobacter spp (97.2%) and P. aeruginosa (76.2%) About 28.6 % of E. coli, 8.33% of Klebsiella spp and 2.4 % of Pseudomonas aeruginosa were ESBL producers. Acinetobacter spp. was not found to produce ESBL during the study. MBL was present in 17.4% of the gram negative isolates. Conclusion: We found a high prevalence of MDR strains as a cause of nosocomial LRTI including significant proportions of ESBL and MBL producers. The rate of Acinetobacter spp., including MBL producers, in our hospital setting was alarmingly high which prompts a special attention for the management of such patients as well as urgent need for implementation of infection control strategies.

Respiratory tract

Multi drug resistant

10.59779/jiomnepal.431

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Incidence of Bacteremia and Septicemia in patients attending in tertiary care center, Nepal

Journal of Institute of Medicine Nepal (2013)

Ranjit Kumar Chaudhary Srijana Karmacharya Sushan Man Shrestha RK Dahal SK Mishra

Introduction: Bacteremia and septicemia is life threatening condition resulting in major cause of mortality and morbidity.The aim of study was to determine the etiology of bacteremia and septicemia with antibiotic sensitivity profile of those organisms. Methods: A prospective study was carried out among the suspected cases from both inpatient and outpatient of TUTH from October 2009 .March 2010. Blood samples were collected and processed according to standard methodology. Results: Out of 2259 samples only 237 (10.49 %) showed bacterial growth. The most common isolates among Salmonella group was Salmonella enterica serotype typhi 71(29.95%) followed by Salmonella enterica serotype Paratyphi A 45(18.98%). Among non Salmonella group Pseudomonas aeruginosa 34(14.34%), Klebsiella pneumoniae 22(9.28%), Acinetobacter spp 15 (6.32%), Citrobacter spp 5(2.10%), Escherichia coli 3(1.26%) while Staphylococcus aureus 34 (14.3%) was most common followed by Enterococcus spp 3(1.26%), Streptococcus spp 2(0.84%), Coagulase Negative Staphylococcus 2(0.84%) and Listeria spp 1(0.42%) among Gram Positive organisms. Antibiogram revealed Cefotaxime, Ceftazidime, Azithromycin and Chloramphenicol for Salmonella group while for non Salmonella Imipenem, Meropenem and Amikacin as most effective antibiotics while Clindamycin, Cipro!oxacin and O!oxacin for gram positive. Conclusion: Gram negative bacteria was the predominant organism causing bacteremia and septicemia. Among them salmonella typhi and salmonella paratyphi were the leading aetiology. DOI: http://dx.doi.org/10.3126/joim.v34i3.8915 Journal of Institute of Medicine, December, 2012; 34:32-38

Bacteremia

Salmonella enterica

Amikacin

10.3126/joim.v34i3.8915

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