Background: Methicillin resistant Staphylococcus aureus is a global health challenge nowadays creating problem in antibiotic therapy. This study was aimed to generate resistance pattern of Methicillin resistant Staphylococcus aureus to various antibiotics in order to formulate antibiotic policy for control of Methicillin resistant Staphylococcus aureus in Nepal.Methods: This was a cross-sectional study conducted at the department of Clinical Microbiology, Nepal Medical College Teaching Hospital, from April 2015 to March 2016. A total of 142 S. aureus isolated from various clinical specimens. were screened for Methicillin resistant Staphylococcus aureus by cefoxitin disc method according to Clinical and Laboratory Standards Institute guidelines.Results: Out of 142 S. aureus isolates, 30 (21.1%) were detected as Methicillin resistant Staphylococcus aureus by cefoxitin disc method. Most of the Methicillin resistant Staphylococcus aureus (25/30) were isolated from pus which were collected from OPD patients. Antibiotic sensitivity pattern showed all Methicillin resistant Staphylococcus aureus isolates were sensitive to vancomycin.Conclusions: Prevalence of Methicillin resistant Staphylococcus aureus was found to be 21.1%, and all Methicillin resistant Staphylococcus aureus appear 100% sensitive to vancomycin. Keywords: .

Escherichia coli and Klebsiella spp. are two important uropathogens showing resistance to beta-lactams by producing extended spectrum beta lactamase (ESBL), leading to difficulty in treating infections with these bacteria. Majority of the ESBLs are of TEM, CTXM and SHV types reported from Nepal. This study was conducted in Clinical Microbiology Department of Nepal Medical College Teaching Hospital from November 2021 to mid-January 2022 to determine prevalence of ESBL and antimicrobial susceptibility pattern among two common uropathogens. A total of 402 E. coli and Klebsiella spp. isolated from urine samples were included in the study. ESBL producing strains were identified by combination disc method and antibiotic susceptibility testing was done by Kirby Bauer’s disc diffusion method. PCR was done to detect the TEM and CTXM genes. Prevalence of ESBL among E. coli and Klebsiella spp. was found to be 14.9% (60/402). Among the E. coli, 16.1% (58/360) and only 4.8% (2/42) of Klebsiella spp. were ESBL producers. Antibiogram showed, 56.7% ESBL producers were susceptible to ciprofloxacin, 46.7% to co-trimoxazole, 96.7% to nitrofurantoin. However, all isolates were susceptible to amikacin, piperacillin-tazobactam, and carbapenems (both meropenem and imipenem). Among total 30 ESBL isolates selected by systematic random sampling, 3 isolates (all three E. coli) showed presence of TEM and 3 other isolates (two E. coli and one Klebsiella spp.) showed CTXM genes.

Introduction: Ampicillinase C beta-lactamase-producing organisms are often resistant to multiple antimicrobial agents, and therapeutic options against these pathogens are limited. Limited information is available regarding Ampicillinase C beta-lactamase producers. The aim of this study was to find out the prevalence of Ampicillinase C beta-lactamase producers among isolates of Enterobacteriaceae in a tertiary care centre. Methods: A descriptive cross-sectional study was carried out in the Clinical Microbiology Laboratory of a tertiary care centre from May 2021 to October 2021. Ethical approval was received from the Institutional Review Committee (Reference number: 044-077/078). Isolates of Enterobacteriaceae from various clinical samples were collected by convenience sampling. Ampicillinase C screening for beta-lactamase producers among the Enterobacteriaceae isolates was done using cefoxitin (30 μg) disc. Detection of Ampicillinase C beta-lactamase producers among the screen-positive isolates was done by cefoxitin-cloxacillin double-disc synergy test. An increase in the zone size of ≥4 mm was considered as Ampicillinase C beta-lactamase producers. Point estimate and 95% Confidence Interval were calculated. Results: Among the total 481 isolates of Enterobacteriaceae, 49 (10.19%) (7.50-12.90, 95 % Confidence Interval) were detected as Ampicillinase C beta-lactamase producers among isolates of Enterobacteriaceae. Conclusions: The prevalence of Ampicillinase C beta-lactamase producers was lower than in other studies done in similar settings. Meropenem could be a drug of choice for the treatment of infections due to Ampicillinase C beta-lactamase-producing gram-negative bacteria.

Background: Widal tube agglutination test is a widely used laboratory test for diagnosis of enteric fever   especially in resource limited countries where blood culture are not routinely available. We studied the titres from different groups including febrile and healthy populations in order to identify the significant agglutination titre. Materials and Methods: This was a hospital based cross-sectional study. Subjects were divided into three groups: 1) 60 healthy blood samples from volunteer students, 2) 60 febrile non-typhoidal cases and 3) 58 culture positive patient for enteric fever. Results: Among 60 apparently healthy volunteers, agglutination of ≥ 1:20 for anti O and anti-H titres against serotype Typhi were seen in 40 and 46 samples respectively. A significant proportion of   sample had a titre of ≥1:80 (n=19) and 1:160 (n=14) for anti O and anti-H titres against serotype Typhi respectively among healthy individuals. Similar observations were seen in febrile non typhoidal cases except for one which had a titre of ≥1:320 for anti O and anti-H titres against serotype Typhi. In blood culture positive typhoid cases, 56 samples showed agglutinations of ≥1:80 for both anti O and anti-H titres against serotype Typhi. However two of the total sample tested showed no agglutinations. In all cases from three groups, anti-H titre for S. enterica serotype Paratyphi A and B were below 1:80. Conclusions: Widal test can be used as presumptive diagnostic tool in all the suspected cases of enteric fever if the titres are specifically raised.Keywords: enteric fever; titre; widal aggultination test.