Present study was conducted to determine the prevalence of nosocomial pathogen methicillin resistant Staphylococcus aureus in hospital environment samples (surface swabs and air, n=188) and health care workers (nose and hand, n=162) of hospitals located in Kathmandu valley. The samples were studied following the standard protocols. Of the 61 S. aureus, 20.9% and 14.3% were isolated from health personnel and hospital environment respectively. Of 20.9% S. aureus in hospital environment, 6.6% were isolated from OPD and 17.9% from wards. Similarly, in HCWs 28.3% and 13.5% were hand and nasal carrier respectively. In total, 45.9% were MRSA. Among MRSA isolates, 50% were from HCWs whereas, 40.7% from hospital environment. The most effective antibiotic for all isolates was vancomycin with 100% efficacy. The isolates had relatively high rate of resistance to cefixime (44.0%), followed by co-trimoxazole (28.0%), erythromycin (23.0%), gentamicin (18.0%), tetracycline (16.0%) and ofloxacin (8.0%). Since MRSA prevalence was not reduced, so indicates regular surveillance of nosocomial infection, hand hygiene improvement strategies and monitoring of antimicrobial susceptibility pattern.

Background: Tooth brushing with toothpaste is the most widely practiced form of oral hygiene. Toothpaste aids to improve oral hygiene and effective plaque removal. A wide range of chemicals, mainly antimicrobial agents, have been added to toothpastes which kill microorganisms by disrupting their cell walls and inhibiting their enzymatic activity.Objectives: The aim of the study was to determine the antimicrobial activity of toothpastes.Methods: Eight (Two herbal and six regular) toothpastes were selected for the study. The study was conducted from October to November 2016 at St. Xavier’s College’s microbiology laboratory. Antimicrobial activity of toothpastes were assessed by measuring inhibition zones by broth dilution method and agar well diffusion method.Results: Minimum Inhibitory Concentration determination by tube dilution method and cup well diffusion method was found to be same. The antimicrobial activity on test organisms was shown by all toothpastes (TH1, TH2, TR3, TR4, TR5, TR6, TR7 and TR8). Antimicrobial activity of all toothpastes were almost the same and was statistically significant (t>0.05)Conclusion: All eight toothpastes aids in lower microbial load. However, no toothpaste showed bactericidal and fungicidal effect against the tested microbes. The toothpaste containing only natural active ingredients were found to be more effective than the toothpaste containing chemical active agent followed by weaker antimicrobial effect given by the toothpaste containing both natural and chemical active ingredient as an antimicrobial agent.

Actinomycetes are Gram positive, free living saprophytes which are distributed in soil as one of the major populations and are primary source of antibiotics. This study was carried out with a quest to isolate actinomycetes from soil samples of different places and assess their antibacterial activity. Isolation of actinomycetes was carried out by serial dilution of soil sample followed by spread plate method. The antimicrobial extract was extracted using ethyl acetate. Assessment of antimicrobial activity was performed by using Agar cup plate assay against test organisms (Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, Salmonella typhi, Salmonella paratyphi, Bacillus subtilis, Staphylococcus aureus). Antibacterial activity was tested against Methicillin Sensitive Staphylococcus aureus and Methicillin Resistant Staphylococcus aureus in the isolates having effective inhibitory activity against Staphylococcus aureus. From 15 soil samples of 12 different locations, 121 actinomycetes isolates were isolated. Among them, 58 (47.9%) isolates were inhibitory against at least 1 test organism in primary screening, of which 22 isolates effective against more than 1 test organism was chosen for secondary screening. Out of them, 8 were inhibitory against 2 test organisms while 14 were inhibitory against 3 test organisms. Staphylococcus aureus was found to be the most susceptible test organism with its susceptibility against 12 actinomycetes isolates. Among 12 isolates effective against Staphylococcus aureus, 10 were found to have an inhibitory effect against Methicillin Susceptible Staphylococcus aureus while 6 were found to have inhibitory effect against Methicillin Resistant Staphylococcus aureus strain. The findings of this study highlight the inhibitory potential of actinomycetes and the need for further investigation for obtaining novel antimicrobial agents from actinomycetes from various unexplored areas.

BackgroundFebrile-infection related epilepsy syndrome (FIRES) is a rare epilepsy syndrome in which a previously healthy individual develops refractory status epilepticus in the setting of a preceding febrile illness. There are limited data regarding detailed long-term outcomes. This study aims to describe the long-term neuropsychological outcomes in a series of pediatric patients with FIRES.MethodsThis is a retrospective multi-center case series of pediatric patients with a diagnosis of FIRES treated acutely with anakinra who had neuropsychological testing at least 12 months after status epilepticus onset. Each patient underwent comprehensive neuropsychological evaluation as part of routine clinical care. Additional data collection included the acute seizure presentation, medication exposures, and outcomes.ResultsThere were six patients identified with a median age of 11.08 years (IQR: 8.19–11.23) at status epilepticus onset. Anakinra initiation was a median of 11 days (IQR: 9.25–13.50) after hospital admission. All patients had ongoing seizures and none of the patients returned to baseline cognitive function with a median follow-up of 40 months (IQR 35–51). Of the five patients with serial full-scale IQ testing, three demonstrated a decline in scores over time. Testing results revealed a diffuse pattern of deficits across domains and all patients required special education and/or accommodations for academic learning.ConclusionsDespite treatment with anakinra, neuropsychological outcomes in this series of pediatric patients with FIRES demonstrated ongoing diffuse neurocognitive impairment. Future research will need to explore the predictors of long-term neurocognitive outcomes in patients with FIRES and to evaluate if acute treatment interventions improve these outcomes.

Wound infections result in sepsis, limb loss, long hospital stays, higher costs, and are responsible for significant human mortality and morbidity worldwide. The present study was conducted to isolate and identify the causative organisms of wound infection, to determine the antibiotic susceptibility pattern of the isolates and to study the risk factors for wound infection. The study was conducted for six months in which pus specimens collected from 244 patients were processed to investigate etiological agents using standard technique. Disc susceptibility of bacterial agents were then determined. A total of 244 pus samples were collected and 147 (60.20%) samples showed growth. A total of 150 bacterial isolates were isolated; of which 118 (78.67%) were Gram positive and 32 (21.33%) were Gram negative bacteria. Staphylococcus aureus (72.00%) was most common followed by Escherichia coli (6.67%), Citrobacter freundii (5.34%), Staphylococcus epidermidis (4.00%), Pseudomonas aeruginosa (3.33%), Proteus mirabilis (2.00%), Enterococcus faecalis (1.33%), Acinetobacter spp. (1.33%), Klebsiella oxytoca (1.33%), Klebsiella pneumoniae (1.33%), Streptococcus pneumoniae (0.67%) and Streptococcus pyogenes (0.67%). The most effective antibiotic for Gram positive isolates was Gentamicin (77.97%). For Gram negative isolates (except Ps. aeruginosa), Amikacin (74.07%), for Ps. aeruginosa, Amikacin, Ciprofloxacin, Gentamicin and Ofloxacin each with the susceptibility of 80.00% and for Staph. aureus, Cloxacillin (79.63%) were the most effective antibiotics. Hence, the most common isolate in wound infection was Staph. aureus followed by E. coli. Therefore, routine microbiological analysis of the wound specimens and their antibiotic susceptibility testing is recommended that will guide clinician for treatment of wound infection.