Background: Candida albicans remains the most common and are responsible for various clinical infections ranging from mucocutaneous infection to life threatening invasive diseases. But recent epidemiological data shift from C.albicans to non albicans Candida species and also increased resistance to antifungal drugs made the scenario a serious concern. Methods: A total of 156 Candida isolates from various clinical specimens received in the department of Microbiology were taken up for the study over a period of one year i.e. from March 2019 to February 2020. The Candida were grown on Sabouraud dextrose agar to be  evaluated for colony  appearance, macroscopic examination, Gram staining, germ tube, urea hydrolysis etc. The Candida isolates were speciated by using CHROMagar medium. Antifungal susceptibility testing was performed as recommended by Clinical and Laboratory Standards Institute (CLSI) M44-A document. Results: The isolation of non albicans Candida (54.5%) predominated over Candida albicans (45.5%). Non albicans Candida isolated were Candida tropcalis 40(25.6%), Candida krusei 21(13.4%), Candida glabrata 17(10.8%) and Candida dublinensis 07(4.4%) each. Candida species were all susceptible to Amphotericin B, followed by fluconazole (67.4%), miconazole (51.9%) and ketoconazole (22.5%). Conclusions: The accurate species identification of Candida is important for the treatment because not all species respond to the same treatment and also because of the increasing antifungal resistance. CHROMagar is a convenient and rapid method of identification of Candida species specially in resource limited poor settings.   Keywords: antifungal susceptibility testing; Candida albicans; CHROMagar; non albicans Candida

Background: The patients with head injury have reduced consciousness, they are prone to aspirations of oral secretions. The tracheotomized patients are colonized mostly by gram negative bacteria and are likely develop pneumonia causing life threatening consequences due to severe, persistent, resistant infections. This study was undertaken to identify the common organisms which cause respiratory tract infection and their Antibiogram of ventilated patients in Neurosurgical Intensive Care Unit.  Methods: A cross-sectional study was conducted to determine the prevalence and antibiotisc susceptibility analysis of Endotracheal aspirates of the patients who were admitted in Neurosurgical intensive care unit, College of medical sciences, teaching hospital, Bharatpur, for a period from October 2019 to July 2020. Aspirates were cultured onto Blood agar, McConkey and Chocolate agar. Isolation and identification was done using conventional techniques and Biochemical reactions. Antibiotic susceptibility was done by Kirby-Bauer disc diffusion method as per CLSI guidelines. Results: Out of 163 samples, 147(90.18%) were culture positive. 78 samples were found to be polymicrobial. 16 samples showed no growth. Acinetobacter baumanii (36.05%) was the most common isolate followed by Enterobacter sp (25.85%), Klebsiella pneumoniae (15.65%), Pseudomonas aeruginosa (13.61%), Escherichia coli (5.44%), Citrobacter freundii (2.04%), and Staphylococcus aureus (1.36%). The gram negative bacilli were all sensitive to colistin. Comparatively, they were also sensitive to Imipenem, Meropenem, Cefaperozone/sulbactam. Staphylococcus aureus is sensitive to Vancomicin. Conclusions: Respiratory tract infection in intubated patients is risk factors which lead to morbidity and mortality. Inappropriate and inadequate antibiotic treatment causes emergence of drug resistance in pathogens and poor prognosis in patients. The study reported the alarming condition of MDR in tracheal aspirates. Hence, surveillance for source of multi drug resistant bacteria would be beneficial for intervention of infection related to it.

Background: Intestinal parasitic infections are important public health problem and are globally endemic. These parasites are responsible for the major share of morbidity and mortality in those communities where there is overcrowding, poor environmental sanitation and personal hygienic practices. Intestinal parasitic infection is highly prevalent among the general population in Nepal. This study was aimed to evaluate the burden of the intestinal parasitic infections and the pattern of distributions among patients attending in a tertiary care setting in Bharatpur, Nepal, over a period of one year (August 2017 to July 2018). Methods: Stool samples of patients received in the Microbiology laboratory, COMS that were subjected for routine stool investigations were included in this study. Naked eye physical examination, microscopic examination was carried out and parasites were identified in the received stool samples. The results were recorded, and data were entered into excel spreadsheet 2007. The percentages of the parasites present were calculated to find out the frequency and distribution. Results: A total of 1,558 fresh stool samples were screened, of which 20.60% (n=321) were positive for various intestinal parasites. Overall, helminthic infections (81.30%) were higher than protozoal infections (18.70%). On the whole, Ascaris lumbricoides showed higher prevalence (39.56%) followed by Ancylostoma duodenale (19.31%) and Giardia lamblia (9.97%).  17(1.09%) of the samples showed more than one parasite. Highest prevalence was seen in age group 15 to 25 years of age (27.40%). Conclusions: Parasitic infection is endemic. Apart from the early diagnosis and effective treatment, health education is a requisite to control infections in this area and awareness of sanitation to reduce and control parasitic infection.