Background: Methicillin Resistant Staphylococcus aureus (MRSA) is a significant human pathogen associated with nosocomial infections. mecA in the S. aureus is a marker of MRSA. The main objective of this study was to detect mecA and vanA genes conferring resistance in S. aureus among cardiac patients attending Sahid Gangalal National Heart Centre (SGNHC), Kathmandu, Nepal between May and November 2019. Methods: A total of 524 clinical samples (blood, urine, sputum) were collected and processed. Bacterial isolates were tested for antimicrobial susceptibility test (AST) and screening for MRSA was carried out by cefoxitin disc diffusion method. Minimum inhibitory concentration (MIC) of vancomycin for MRSA was established by agar dilution method and chromosomal DNA was extracted and used in polymerase chain reaction targeting the mecA and vanA genes. Results: Out of 524 specimens, 27.5% (144/524) showed bacterial growth. Among 144 culture positive isolates, S. aureus (27.1%; 39/144) was the predominant bacteria. Among 39 S. aureus isolates, all isolates were found resistant to penicillin followed by erythromycin (94.9%; 37/39), gentamicin (94.9%; 37/39) and cefoxitin (87.2%; 34/39). Out of 39 S. aureus, 87.2% (34/39) were MRSA. Among 34 MRSA, 8.8% (3/34) were vancomycin intermediate S. aureus (VISA). None of the MRSA was resistant to vancomycin. All of the 3 VISA isolates were obtained from inpatients. Of 39 S. aureus, 82.1% (32/39) harbored mecA gene. Similarly, the entire VISA isolates and 94.1% (32/34) of the MRSA isolates were tested positive for mecA gene. Conclusions: High prevalence of MRSA among the cardiac patients indicates the increasing burden of drug resistance among bacterial isolates. Since infection control is the crucial step in coping with the burgeoning antimicrobial resistance in the country, augmentation of diagnostic facilities with routine monitoring of drug resistance is recommended.

Different types of resource conservation technology (RCT) in wheat cultivation have been recently introduced and use of seed cum fertilizer zero till drill machine is one of them which was used in eastern terai region in wheat season of 2006/2007. A survey was carried out to study the productivity of wheat and compare the production between traditional and RCT method of cultivation. Altogether 31 farmers were interviewed with semi-structured questionnaires. Model used to estimate the productivity for both the methods was significant (p < 0.01) which explained 96 and 97 per cent variation due to independent variables under study in wheat production of traditional and RCT method, respectively. Farmers used 160 kg seed/ha in traditional method while in RCT method it was 122 kg/ha. Similarly, they applied 148 and 137 kg nutrients as a total of nitrogen, phosphorus and potash in traditional and RCT method, respectively. Average production of wheat grain in traditional and RCT method was 2456 and 2714 kg/ha giving average gross margin of Rs 16750.00 and Rs 23301.00/ha, respectively. This revealed 10 per cent reduction in total costs and 29 per cent increase in return by RCT method.Nepal Agric. Res. J. Vol. 9, 2009, pp. 99-108DOI: http://dx.doi.org/10.3126/narj.v9i0.11647

The ability of pathogenic Escherichia coli to produce carbapenemase enzymes is a characteristic that allows them to resist various antibiotics, including last-resort antibiotics like colistin and carbapenem. Our objectives were to identify rapidly developing antibiotic resistance (AR), assess β-lactamases production, and detect mcr-1 and blaNDM-1 genes in the isolates. A prospective cross-sectional study was carried out in a referral hospital located in Kathmandu from November 2019 to December 2020 using standard laboratory and molecular protocols. Among 77 total E. coli isolates, 64 (83.1%) of them were categorized as MDR. Phenotypically 13 (20.3%) colistin-resistant, 30 (46.9%) ESBL and 8 (12.5%) AmpC producers, and 5 (7.8%) ESBL/AmpC co-producers were distributed among MDR- E. coli. Minimum inhibitory concentrations (MIC) against the majority of MDR isolates were exhibited at 1 g/L. Of these 77 E. coli isolates, 24 (31.2%) were carbapenem-resistant. Among these carbapenem-resistant bacteria, 11 (45.9%) isolates were reported to be colistin-resistant, while 15 (62.5%) and 2 (8.3%) were MBL and KPC producers, respectively. Out of 15 MBL producers, 6 (40%) harbored blaNDM-1, and 8 (61.5%) out of 13 colistin-resistant pathogens possessed mcr-1. The resistance by colistin- and carbapenem were statistically associated ( P < .001). However, only 2 (18.2%) of the co-resistant bacteria were found to have both genes. Our study revealed the highly prevalent MDR and the carbapenem-resistant E. coli and emphasized that the pathogens possess a wide range of capabilities to synthesize β-lactamases. These findings could assist to expand the understanding of AR in terms of enzyme production.

Insertion sequence contributes to the emergence of carbapenem resistance by dissemination of carbapenemase genes and providing promoter for their overexpression. This study aims to ascertain the occurrence of ISAba1-linked OXA carbapenemase genes and its relevance to carbapenem resistance level in Acinetobacter baumannii. This hospital based descriptive study was conducted at Shahid Gangalal National Heart Center, Kathmandu, Nepal. An overall of 1,291 clinical specimens received for routine culture and antibiotic susceptibility testing throughout the study period were included in this study. Identification of Acinetobacter baumannii was validated through detection of intrinsic blaOXA-51-like gene by polymerase chain reaction (PCR). Antibiotic susceptibility was tested by Kirby-Bauer disc diffusion approach and minimum inhibitory concentration (MIC) of meropenem was assessed through agar dilution method. Uniplex PCR assays were performed to detect genes encoding oxacillinases and ISAba1. Upstream association of insertion element, ISAba1 to oxacillinase genes was assessed through PCR mapping strategy using ISAba1F and OXA-51R/OXA-23R primers. Out of the 340 bacteria isolated, only 40 (11.8%) were Acinetobacter baumannii. All isolates were resistant against meropenem with MIC value ranging from 16-256 μg/ml. blaOXA-23-like genes was present in every isolate but blaOXA-58 in just two isolates (5%). All isolates had ISAba1 either above blaOXA-23-like or blaOXA-51-like gene. Higher MIC90 value of meropenem (243.20 μg/ml) was found in A. baumannii cluster with ISAba1-linked upstream to both blaOXA-23-like and blaOXA-51-like genes, thus depicting their eminent role to enhanced carbapenem resistance. Acinetobacter baumannii isolates with ISAba1-linked oxacillinase genes are rapidly emerging in clinical settings of Nepal. Thus, medical communities need to be prepared and enable targeted approaches for managing burgeoning problem of carbapenem resistance.