LOWER RESPIRATORY TRACT PATHOGENS AND THEIR ANTIMICROBIAL SUSCEPTIBILITY PATTERN IN A MEDICAL HOSPITAL OF CENTRAL NEPAL

 Sony Shrestha*1, Anju Acharya2, Hari Prasad Nepal3, Rajendra Gautam4, Shamshul Ansari5, Goma Upadhyay6 and Avisekh Gautam7

1,5Lecturer, 2Associate professor, 3,4Assistant Professor, 6Assistant Lecturer, Department of Microbiology, Chitwan Medical College (CMC), Chitwan, Nepal. 
7Lecturer, Department of Microbiology, St. Xavier’s College, Kathmandu, Nepal.

Abstract

Background: Lower respiratory tract infection (LRTI) is one of the major causes of morbidity and mortality in young children and elderly people. It is among top ten diseases of Nepal and accounts for deaths of 2.6 million people per year.

Objectives: To identify causative agents of lower respiratory tract infection and to determine their susceptibility to antimicrobial agents, with special interest to multidrug resistance (MDR).


Materials and Methods: The study was carried out in 240 sputum specimens received in the Microbiology Laboratory of Chitwan Medical College Teaching Hospital within a period of 6 months (April- September, 2010).  Results: Total positive result was observed in 73 specimens (30.42%). Infection rate in males (58%) was higher than in females (42%). LRTI was mostly seen in age group of 61-75 years. Altogether 9 different species of bacteria were identified, majority of which were Gram-negative bacteria (73%). On performing antimicrobial susceptibility testing, Gram-positive organisms exhibited maximum sensitivity to gentamicin (100%) while Gram-negative bacteria showed variable response towards different antimicrobials. Prevalence of MDR was higher in Enterobacter spp (100%) followed by Escherichia coli (90%).



Conclusion: Varieties of pathogens are responsible for LRTI and antimicrobial resistance has become significant public health problem in central Nepal.


Keywords: Antimicrobial susceptibility, bacterial isolates, LRTI, MDR, Nepal  

BACTERIOLOGICAL PROFILE OF NEONATAL SEPTICEMIA CASES AND THE ANTIMICROBIAL RESISTANCE PATTERN IN A TERTIARY CARE HOSPITAL OF CENTRAL NEPAL

Hari Prasad Nepal^1*, Anju Acharya², Rajendra Gautam³, Sony Shrestha⁴, Rama Paudel⁵

^1,3Assistant Professor, ²Associate Professor, ⁴Lecturer, Department of Microbiology, Chitwan Medical College (CMC) Teaching Hospital; ⁵Resident, Department of Pharmacology, College of Medical Sciences, Chitwan, Nepal

ABSTRACT

Background: Neonatal septicemia is an important cause of morbidity and mortality. Knowledge of bacteriological profile and antimicrobial susceptibility is very important for management of such infection.

Objective: To determine the bacteriological profile of neonatal septicemia and the antimicrobial resistance pattern.

Materials and Methods: A total of 377 neonatal blood cultures samples were processed in the Department of Microbiology, Chitwan Medical College Teaching Hospital, Nepal in one year period. Isolation, identification and antimicrobial susceptibility was determined by standard microbiological methods.

Results: Of 377 specimens studied, bacterial growth was obtained in 80 specimens (2.1%). Gram-positive organisms were isolated in 35 (43.7%)  and Gram-negative in 45 (56.3%) specimens. Staphylococcus aureus was the most common organism (23/70 isolates) isolated in early-onset septicemica followed by Acinetobacter species (18/70 isolates) and Klebsiella species. However, late-onset septicemia was primarily  associated with Acinetobacter species (4/10 isolates).

On performing antimicrobial susceptibility testing, Gram-positive organisms exhibited maximum resistance to Cotrimoxazole (100%) followed by Penicillin (75%) and Cephalexin (50%) while Gram-negative organism to Norfloxacin (100%) followed by Cefixime (90.6%), Cotrimoxazole (80%) and Ceftriaxone (78.5%) among all antibiotics tested.

Conclusion: A wide spectrum of antimicrobial resistant bacterial agents are responsible for neonatal septicemia in our set up. A longitudinal surveillance program coupled with good infection control practices and rational use of antibiotics is important to reduce infection rate and ensure better therapeutic success.

Keywords: Neonatal septicemia, bacteriological profile, antimicrobial resistance, Nepal