Application of WHONET in the Antimicrobial Resistance Surveillance of Uropathogens: A First User Experience from Nepal

Ghosh, Arun; Bhatta, Dwij Raj; Ansari, Maliha; Tiwari, H K; Mathuria, J P; Gaur, Abha; Supram, H S; Gokhale, Shishir

doi:10.7860/jcdr/2013/5193.2955

Cited by 12 publications

(14 citation statements)

References 12 publications

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“…Nearly 20% of E. faecium were resistant to vancomycin and 12% to Teicoplanin. In Nepal VRE in clinical isolate was reported from Manipal teaching hospital (one isolate) by disc diffusion method 54 and one VRE (MIC=32 mcg/ml) from case of peritonitis patient in a continuous ambulatory patient in B.P Koirala institute of health science 55 . These studies are probably the only available reports on clinically isolated VRE detected by agar dilution method in Nepal till date as mentioned by Amatya et al 13 .…”

Section: Discussionmentioning

confidence: 99%

Characterisation of "ESKAPE" Pathogens with Special Reference to Multidrug Resistance and Biofilm Production in a Nepalese Hospital

Pandey

Shrestha

Mishra

2019

Preprint

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Background: “ESKAPE” is an acronym for group of organisms as Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter calcoaceticus baumannii complex, Pseudomonas aeruginosa and Enterobacter spp. They are associated in causing life threatening infections. Global efforts on controlling multidrug resistant (MDR) organisms have been hampered by their rapid emergence, inadequate tests for rapid detection and their ability to escape the antibacterial drugs. The objective of this study was to determine the prevalence of ESKAPE pathogens with prime focus on biofilm production and antibiotic resistance. Methods: A total of 8756 clinical specimens were processed for the isolation and identification of ESKAPE pathogens following standard microbiological protocol. These isolates were subjected to antibiotic sensitivity test as per Clinical and Laboratory Standards Institute (CLSI) guidelines. Detection of resistance phenotypes, viz., extended-spectrum-beta-lactamase (ESBL), metallo-beta-lactamase (MBL), Methicillin-resistant Staphylococcus aureus (MRSA), Vancomycin-resistant enterococci (VRE) was done by disk diffusion method and E- test method as applicable. The VRE isolates were subjected for detection of Van A and Van B genes. All the isolates were processed for biofilm detection by tube adherence method. Results: The percentage distribution of Staphylococcus aureus was 33.5%, followed by Klebsiella pneumoniae 33.0%, Pseudomonas aeruginosa 18.3%, Acinetobacter calcoaceticus baumannii complex 8.7%, Enterococcus faecium 5.6% and Enterobacter aerogenes 0.9%. MRSA was 57.6% and Vancomycin resistance among Enterococcus faecium was 20%. ESBL and MBL producing Klebsiella pneumoniae were 16.1%, and 8.1%, Acb complex 10.3% each and Pseudomonas aeruginosa 10.7% and 8.3% respectively. A total of 42.3% of isolates were biofilm producers. Linezolid was drug of choice for VRE isolates. Piperacillin- tazobactam was found to be effective against Pseudomonas aeruginosa, Klebsiella pneumoniae and Enterobacter aerogenes; Ampicillin-sulbactam was the most effective drug against Acb complex excluding polymyxins. Van A gene was detected in all the VRE isolates. Conclusion: This study estimates the burden of the ESKAPE organisms and their antibiotic resistance pattern in a Nepalese hospital. The increasing percentages of drug resistance among these biofilm-producing pathogens pose great threat in medical setting. Surveillance targeting ESKAPE pathogens should be incorporated in infection control policy in Nepal.

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Section: Discussionmentioning

confidence: 99%

Characterisation of "ESKAPE" Pathogens with Special Reference to Multidrug Resistance and Biofilm Production in a Nepalese Hospital

Pandey

Shrestha

Mishra

2019

Preprint

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“…Investigators from western Nepal have reported VRE by disc diffusion method however they did not confirm their findings by MIC determination. 13 Amatya et al 12 11 previously in hospital from eastern Nepal. In this study all these VIE isolates were from inpatients samples and were resistant to ampicillin, ciprofloxacin, erythromycin and HLG.…”

Section: Discussionmentioning

confidence: 98%

“…has been reported also from Nepal. [11][12][13] It does raise the question of whether the antimicrobial resistance pattern among these bacteria in Nepal has changed. Improved knowledge of local and regional epidemiology and susceptibility patterns of bacteria is crucial in order to optimize empiric antibiotic treatment strategies.…”

Section: Introductionmentioning

confidence: 99%

Antimicrobial Susceptibility Pattern of Enterococcus Species Isolated from Various Clinical Specimens in a Tertiary Care Hospital, Kathmandu, Nepal

et al. 2018

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Resistance to vancomycin and high level aminoglycosides are common among Enterococcus spp. and are being increasingly reported from different parts of the world. These resistance phenomena in enterococci have limited the therapeutic options to treat the infections caused by them. The objective of our study was to determine the antimicrobial resistance patterns of Enterococcus spp. (n=60) isolated over a year from clinical specimens received from patients visiting Nepal Medical College Teaching Hospital, Kathmandu, Nepal. All enterococci were subjected to antimicrobial susceptibility testing, high level gentamicin resistance testing by disc diffusion method and minimum inhibitory concentration of vancomycin by agar dilution method. Prevalence of high level gentamicin resistance among enterococci was 55%. None of the isolates were resistant to vancomycin by both disc diffusion and agar dilution method. However 8.3% of them were intermediate to vancomycin. All of these vancomycin intermediate isolates were from samples from hospital admitted patients and resistant to ampicillin, ciprofloxacin, erythromycin and high level gentamicin. Present findings were suggestive of possible emergence of vancomycin resistant enterococci in the hospital if immediate and adequate control measures are not implemented.

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“…In the present study high resistance percentages (88%) was reported to chloramphenicol, tetracycline, naldixic acid. However, [23] found the resistant percentages of E. coli to naldixic acid were (86%), while [22] stated that a resistance percentage of E. coli to nalidixic acid was (20%). The resistance to quinolones as naldixic acid in gram-negative bacteria such as E. coli is mainly recalled to a mutation in their chromosome which modifies the targeted enzyme of the bacterium (DNA gyrase) and topoisomerase IV, or enhnce the efflux pump system that drain the drugs out of the cytoplasm.…”

Section: E25 S R R R S R R R S S 60%mentioning

confidence: 99%

Determination the site of antibiotic resistance genes in Escherichia coli isolated From Urinary Tract Infection

Mohammad

Ahmed

Mohammed

et al. 2018

KJAR

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This study includes isolation of 25 isolates of Escherichia coli (E. coli ) strain from urinary tract samples in a pregnant woman. Microbiological and biochemical tests were used to identify the resistant bacteria of this genus. Screening methods were used to determine bacterial isolates for their resistance to 10 antibiotics include: Amikacin (Ak), Amoxicillin (Ax), Ampicillin (Ap), Chloramphenicol (Cm), Ciprofloxacin (Cip), Erythromycin (Er), Nalidixic acid (Nal), Penicillin (Pen), Tetracycline (Tet) and Trimethoprim (Tm). The isolates E4, E9, E16, and E17 were resistant to all antibiotics used in the current study using the disk diffusion method. In contrast, the resistance percentage for all antibiotics ranged between 28-96%. Sites of resistance genes and hemolysin production genes were characterized by tranformation techniques in the E4 and E16. The results showed that the antibiotic resistance genes of Amikacin, Erythromycin, Tetracyclin, and Trimethoprim were located on a plasmid, whereas Amoxicillin, Ampicillin, Chloramphenicol, Ciprofloxacin, Nalidixic acid and Penicillin were located on chromosomal DNA. The results also demonstrated an inability to produce alpha or beta-hemolysin indicating that the genes which are responsible for hemolysin production were also located on chromosomal DNA.

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Application of WHONET in the Antimicrobial Resistance Surveillance of Uropathogens: A First User Experience from Nepal

Cited by 12 publications

References 12 publications

Characterisation of "ESKAPE" Pathogens with Special Reference to Multidrug Resistance and Biofilm Production in a Nepalese Hospital

Characterisation of "ESKAPE" Pathogens with Special Reference to Multidrug Resistance and Biofilm Production in a Nepalese Hospital

Antimicrobial Susceptibility Pattern of Enterococcus Species Isolated from Various Clinical Specimens in a Tertiary Care Hospital, Kathmandu, Nepal

Determination the site of antibiotic resistance genes in Escherichia coli isolated From Urinary Tract Infection

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