Aims: Nosocomial infection is a major problem in the world today. Methicillin-resistant Staphylococcus aureus (MRSA) strains, usually resistant to several antibiotics and also intrinsic resistance to ß-lactam antibiotics, shows a particular ability to spread in hospitals and now present in most of the countries. The present study was carried out to investigate the prevalence of MRSA and their rate of resistance to different antistaphylococcal antibiotics. Materials and methods: Between April 2007 and December 2009, the clinical specimens submitted at the microbiology laboratory were processed and all Staphylococcus aureus (S. aureus) isolates were included in this study. All isolates were identified morphologically and biochemically by standard laboratory procedures and antibiotic susceptibility pattern including oxacillin was determined by modified Kirby Bauer disc diffusion method. Results: Out of a total of 348 Staphylococcus aureus strains isolated from various clinical samples, 138 (39.6%) were found to be Methicillin-resistant. Among MRSA isolates, 86(62.3%) were from different inpatient departments, whereas, 52(37.7%) of the isolates were from outpatients. All MRSA were resistant to penicillin. More than 70% of the MRSA strains were resistant to cephalexin, ciprofloxacin and cloxacillin, while less than 10% of them were resistant to azithromycin, amikacin and tetracycline. Many MRSA strains were multidrug resistant. However, no strains were resistant to vancomycin. Conclusion: This preliminary report showed a high prevalence of MRSA in our hospital. To reduce the prevalence of MRSA, regular surveillance of hospital acquired infection and isolation is the need of the hour. Key words: Nosocomial infection; methicillin-resistant Staphylococcus aureus (MRSA); multidrug resistant. DOI: 10.3126/jcmsn.v6i1.3595 Journal of College of Medical Sciences-Nepal, 2010, Vol. 6, No. 1, 1-6

Background: A retrospective study was done on Asymptomatic Bacteriuria (ASB), among elderly diabetic patients residing in Chitwan, Nepal from 1st January 2006 to 12th December 2006. Diabetic patients above 40 years of age were included in this study where as below 40 years of age group were excluded. Objective: To study the prevalence of ASB among elderly diabetic patients for the Bacteriological profile and their antibiotic susceptibility pattern. Materials and methods: Urine sample was collected from 636 diabetic patients above 40 years age attending College of Medical Sciences Teaching Hospital for regular blood sugar estimation. Culture and Antibiotic susceptibility test (AST) were performed using standard microbiological technique. ASB was determined as presence of ≥ 105 bacteria/ml in a culture of urine sample. Results: The prevalence of ASB among diabetic patients in Bharatpur was found to be 9.43% (12.07% in females and 5.08% in males). The most common bacterial isolate was Escherichia coli (41.66%). Nitrofurantoin, Cefotaxime and Chloramphenicol were the most effective drugs for the majority of isolates. Conclusion: The study shows necessity of regular urine culture to detect ASB, along with blood sugar estimation for diabetic patients to prevent them from further complications due to it. Key words: Diabetic; ASB; Common pathogen and AST DOI: 10.3126/kumj.v7i2.2712 Kathmandu University Medical Journal (2009) Vol.7, No.2 Issue 26, 157-161

Objective The present study has been undertaken to detect the presence of ESBLs producing Klebsiella species in various clinical specimens and their antibiotic susceptibility pattern. Materials and methods The study consists of 60 clinical isolates of Klebsiella species from various clinical specimens submitted to the microbiology laboratory, Kasturba Medical College Teaching Hospital Mangalore over a period of one year, between 1st January 2007 to 31st December, 2007. All isolates were identified morphologically and biochemically by standard procedures and ESBLs production was detected by re-arranging routine discs in a novel predictor disc approximation method. Antimicrobial susceptibility was performed using Kirby-Bauer disc-diffusion method where Imipenem disc, an inducer was placed in center and on either side of it at 15mm distance were placed ceftazidime and cefotaxime (indicator of induction). In addition, another inducer cefoxitin was placed 15mm from cefotaxime (indicator). This was placed opposite to that of ceftazidime + clavulanic acid to avoid any affect of inducible beta-lactamase on the zone of inhibition of the latter. Results A total of 16 out of 60 Klebsiella isolates (26.66%) were found to be ESBL producers. Conclusions Imipenem was found to be the most effective antibiotic (46.66%) followed by Cefoxitin (31.66%) and Cefotaxime (30.00%). Key words: Klebsiella species; clinical specimens; ESBLs DOI: 10.3126/jcmsn.v6i3.4070Journal of College of Medical Sciences-Nepal, 2010, Vol. 6, No. 3 pp.19-23

AimsThe present study is a fundamental effort to evaluate the bacteriological and antibiotic patterns in the Intensive Care Unit (ICU) setting in a tertiary care hospital. This study was carried out to guide the clinician in choosing the appropriate antibiotics and to prevent emergence of multidrug resistance bacteria. Materials and MethodsBetween March 2009 to Feb 2012, the samples from various ICUs that were submitted to the microbiology laboratory for culture and sensitivity were included in this study. All the organisms were identified morphologically and biochemically by standard laboratory procedure and antibiotic susceptibility pattern was determined by disc diffusion methods. ResultOf 3,780 specimens, 2,312 (61.1%) isolates were recovered. Single organisms were isolated from 1,746 (75.5%) samples while the remaining 566 (24.4%) had two or more organisms isolated. Pseudomonas aeruginosa was the most common isolate 819 (35.4%), followed by Klebsiella pneumoniae 637 (27.5%). Antibiotics sensitivity of Pseudomonas aeruginosa showed that almost all isolates were resistant to cephalexin (97.8%) and ciprofloxacin (80.3%). However (95.8%) of the isolates were sensitive to tobramycin, (92.0%) to meropenem & (74.80 %) to amikacin. ConclusionIt is concluded that Pseudomonas aeruginosa is the predominate pathogen isolated from ICUs of this Hospital. Most of the frequently isolated pathogens are resistant to cephalosporins and quinolone antibiotics as compared to aminoglycosides and carbapenem. Regular surveillance of antibiotic susceptibility pattern is very important for setting a guideline to the clinician in choosing an appropriate therapy of infected patients of ICUs.