BackgroundTreatment and prevention of wound infection continues to be a challenging issue in clinical settings of Nepal especially in the context of globally growing problem of antimicrobial resistance. Study on opportunistic pathogens and sensitivity to commonly prescribed local antimicrobial agents are cardinal to reduce the disease burden of wound infections. The aim of this study was to determine the prevalence and antimicrobial susceptibility pattern of methicillin resistant Staphylococcus aureus (MRSA) and extended spectrum β-lactamase (ESBL) producing bacteria from wound infections of patients at a tertiary care hospital in Nepal.MethodsPus specimens were processed using standard microbiological procedures. Antimicrobial susceptibility test was performed following the modified Kirby Bauer disc diffusion technique. Clinical information of patients was obtained from preformed questionnaire and hospital record.ResultsOne hundred eighty two pus specimens from wounds of different body parts: leg, hand, backside, abdominal part, foot, breast and chest, head and neck region were collected and analyzed; 113 bacterial isolates were isolated showing the overall bacterial growth rate of 62%, where the highest rate was among patients of ≤10 years age group (82.1%). A higher rate (68.5%) of bacterial isolates were from inpatients (p < 0.05). Among 116 bacterial isolates, Staphylococcus aureus was the most predominant bacteria (56.9%) followed by Escherichia coli (8.6%), coagulase negative staphylococci (7.8%), Acinetobacter spp. (5.2%), Klebsiella pneumoniae (5.2%), Pseudomonas aeruginosa (4.3%), Enterococcus spp. (4.3%), Citrobacter freundii (2.6%), Proteus vulgaris (1.6%) and P. mirabilis (0.9%). Both Gram positive (73.3%) and negative (78.8%) isolates showed high frequency of sensitive to gentamycin.ConclusionAmong S. aureus isolates, 60.6% were MRSA strains, whereas 40% of K. pneumoniae and 33.3% of C. freundii were ESBL producing bacteria followed by E. coli (25%). It is thus paramount to address the burden of silently and speedily increasing infections caused by drug resistant strains of MRSA and ESBL in Nepal.Electronic supplementary materialThe online version of this article (10.1186/s13756-018-0408-z) contains supplementary material, which is available to authorized users.

Introduction: Hepatic encephalopathy is a condition that impairs the neurological and psychiatric function of a patient as a result of advanced liver disease or portosystemic shunt. Early detection and treatment of hepatic encephalopathy can lessen its severity, length of stay in the hospital and potential fatality. The aim of this study was to find out the prevalence of hepatic encephalopathy among patients with chronic liver disease admitted to the Department of Internal Medicine in a tertiary care centre. Methods: A descriptive cross-sectional study was done among patients with chronic liver disease admitted to the Department of Internal Medicine in a tertiary care centre. Data from 1 October 2021 to 15 May 2023 were collected between 20 May 2023 and 30 May 2023 from the hospital records. Ethical approval was obtained from the Institutional Review Committee (Reference number: 808/2023). The diagnosis was made based on the history, clinical examinations, and gradings were done as per West Haven criteria. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results: Among 389 patients with chronic liver disease, hepatic encephalopathy was seen in 40 (10.28%) (7.26-13.30, 95% Confidence Interval). The mean age of patients was 55.27±13.52 years.Conclusions: The prevalence of hepatic encephalopathy among patients with chronic liver disease was lower than the studies conducted in similar settings.