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.
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.
Introduction: Nosocomial infection is a global problem with multi facet outcomes. At present, the emergence of resistance to antimicrobial agents is a global public health problem which is well pronounced in developing countries. Methods: The aim of this study was to determine the prevalence of bacteria causing nosocomial infections and their antibiotics resistant pattern among the patients admitted at Tribhuvan University Teaching Hospital (TUTH), Kathmandu, Nepal. The study was conducted during a period of March 2011 to February 2012. Nine hundred clinical specimens which included urine, sputum, endotracheal aspirates, pus & blood were subjected for bacterial culture and their antibiotics sensitivity test at the Department of Microbiology with the use of standard method as described by American Society for Microbiology (ASM). Results: Prevalence of bacteria causing nosocomial infection was 34.4% (n=310). Out of 310 specimens, urine 122 (39.30%), sputum 78(25.2%), pus 78(25.2%), endotracheal secreation 24 (7.7%) and blood 8(2.6%). Three hundred thirty three bacteria were isolated from three hundred ten specimens. The most common isolates were Escherichia coli followed by Acinetobacter species, Klebsiella pneumonia and Staphylococcus aureus. In-vitro antibiotic susceptibility tests revealed that the Gram-negatives bacilli were only sensitive to fluroquinolones, ceftrixone, cefepime carbapenem, polymyxin B and colistin sulphate while the Gram-positive cocci were sensitive to fluroquinolones, Ceftroxone, cefepime and vancomycin. Conclusion: The findings suggested the need for constant monitoring of susceptibility of specific pathogens in different populations to commonly used anti-microbial agents to cope up this alarming situation in the hospital for the management of such patients and prevent the dissemination of such strains.
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.
 scale(5.56106)'%3e%3ccircle r='1'/%3e%3cg id='d'%3e%3cg id='c'%3e%3cpath id='b' d='M.195-.98 0-1.39l-.195.408' transform='rotate(11.25)'/%3e%3cuse xlink:href='%23b' transform='rotate(22.5)'/%3e%3cuse xlink:href='%23b' transform='rotate(45)'/%3e%3c/g%3e%3cuse xlink:href='%23c' transform='rotate(67.5)'/%3e%3c/g%3e%3cuse xlink:href='%23d' transform='scale(-1 1)'/%3e%3c/g%3e%3cg transform='translate(0 58.787) scale(8.1434)'%3e%3ccircle r='1'/%3e%3cg id='g'%3e%3cg id='f'%3e%3cpath id='e' d='M.259.966 0 1.576l-.259-.61'/%3e%3cuse xlink:href='%23e' transform='rotate(180)'/%3e%3c/g%3e%3cuse xlink:href='%23f' transform='rotate(90)'/%3e%3c/g%3e%3cuse xlink:href='%23g' transform='rotate(30)'/%3e%3cuse xlink:href='%23g' transform='rotate(60)'/%3e%3c/g%3e%3c/g%3e%3c/svg%3e)
