Bacteriological Profile of Tracheal Aspirates of the Patients Attending Neuro-hospital Nepal

Koirala, Pratirodh; Bhatta, Dwij Raj; Ghimire, Prakash; Pokhrel, Bharat Mani; Devkota, Upendra Prasad

doi:10.3126/ijls.v4i0.3496

Cited by 13 publications

(7 citation statements)

References 13 publications

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“…Multi-drug resistant P. aeruginosa (MDRPA) strains are the most challenging organisms for the clinicians to be overcome. In our study 89.4% of the total isolates from the clinical samples were MDRPA which is similar to a study carried out in Nepal (Koirala et al 2010. In a recent study carried out in a tertiary care hospital in Nepal (Karki et al 2011), MDRPA were also isolated from the clinical samples.…”

Section: Resultssupporting

confidence: 90%

Multi-Drug and Pan-Drug Resistant Pseudomonas aeruginosa: A Challenge in Post- Antibiotic Era

Bhandari

Banjara

Lekhak

et al. 2013

Nepal Journal of Science and Technology

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Clinicians still lack an appreciation of the potential importance of Pseudomonas aeruginosa (PA) in the hospitals. So this study was done in order to isolate and assess the prevalence of multi-drug resistant P. aeruginosa (MDRPA) and pan-drug resistant P. aeruginosa (PDRPA) from the intensive care units (ICUs). A cross-sectional study was conducted for six months at the ICUs of Shahid Gangalal National Heart Centre, Kathmandu. A total of 1,060 samples were processed out of which 700 were clinical samples directly taken from the admitted patients while 360 were the surface swab samples. The isolates were identified using routine conventional methods based upon microscopic findings, colony morphology and biochemical properties. Antibiotic susceptibility testing (AST) was performed by Kirby Bauer disc diffusion technique. P. aeruginosa was isolated from 66 (9.43%) clinical samples while 60 (16.67%) were surface swab samples. Among clinical isolates, 56 (84.8%) were sensitive to cefoparazone+sublactam (CSL) followed by 42 (63.6%) to polymixin-B and 36 (54.5%) to piperacillin-tazobactam (PT), while among surface swab sample isolates more than 90% were sensitive to most of the common antibiotics used. About 59 (89.4%) MDRPA were isolated from clinical samples while it was only 7 (11.7%) from surface swab samples. Only isolates from clinical samples (6.1%) yielded PDRPA. Since P. aeruginosa has shown the reduced susceptibility towards single antibiotics such as carbapenems, fluoroquinolones, aminoglycosides and cephalosporins, combined antibiotics like CSL and PT remained choice of treatment. This can eliminate potential threat of MDRPA and PDRPA in the ICUs. Nepal Journal of Science and Technology Vol. 13, No. 2 (2012) 197-202 DOI: http://dx.doi.org/10.3126/njst.v13i2.7736

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Section: Resultssupporting

confidence: 90%

Multi-Drug and Pan-Drug Resistant Pseudomonas aeruginosa: A Challenge in Post- Antibiotic Era

Bhandari

Banjara

Lekhak

et al. 2013

Nepal Journal of Science and Technology

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“…In this study high growth rate was found from different clinical samples, and similar results have been reported in the previous study carried out at the same hospital [ 15 , 16 ]. Most predominant pathogens in this study were Acinetobacter spp.…”

Section: Discussionsupporting

confidence: 90%

Nosocomial Isolates and Their Drug Resistant Pattern in ICU Patients at National Institute of Neurological and Allied Sciences, Nepal

Bhandari

Thapa

Pokhrel

et al. 2015

International Journal of Microbiology

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Multidrug resistant organisms are increasing day by day and the cause is poorly known. This study was carried out from June 2011 to May 2012 at National Institute of Neurological and Allied Sciences Kathmandu, Nepal, with a view to determining drug resistant pathogens along with detection of extended spectrum β-lactamase (ESBL), AmpC β-lactamase (ABL), and metallo-β-lactamase (MBL) producing bacteria causing infection to ICU patients. A standard methodology was used to achieve these objectives as per recommendation of American Society for Microbiology. ESBL was detected by combined disc assay using cefotaxime and cefotaxime clavulanic acid, ABL by inhibitor based method using cefoxitin and phenylboronic acid, and MBL by imipenem-EDTA combined disk method. Two hundred and ninety-four different clinical samples such as tracheal aspirates, urine, pus, swabs, catheter tips, and blood were processed during the study. Most common bacteria were Acinetobacter spp. Of the total 58 Acinetobacter spp., 46 (79%) were MDR, and 27% were positive for ABL and 12% were for MBL. Of the 32 cases of Staphylococcus aureus, 18 (56%) were MDR. Findings of this study warrant routine β-lactamase testing in clinical isolates.

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“…The results of the study showed high growth rate, which was in accordance with the previous study, which reported culture positivity of 90% [13]. Polymicrobial growth was observed in one-tenth of the cases and the growth of multiple organisms from tracheal specimen has been mentioned in similar studies [14, 15].…”

Section: Discussionsupporting

confidence: 89%

β-Lactamase-Producing Multidrug-Resistant Bacterial Pathogens from Tracheal Aspirates of Intensive Care Unit Patients at National Institute of Neurological and Allied Sciences, Nepal

et al. 2013

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The widespread use of tracheal intubation and mechanical ventilation to support the critically ill patients increases the risk of development of tracheobronchitis and bronchopneumonia. This cross-sectional study was conducted with an aim to isolate and identify bacterial pathogens from tracheal aspirates producing extended-spectrum β-lactamase (ESBL), AmpC β-lactamase, and metallo-β-lactamase (MBL) from August 2011 to April 2012 at National Institute of Neurological and Allied Sciences (NINAS), Kathmandu, Nepal. ESBL was detected by combined disk assay using cefotaxime and cefotaxime with clavulanate, AmpC β-lactamase by inhibitor-based method using cefoxitin and phenylboronic acid, and MBL by Imipenem-EDTA combined disk method. 167 bacterial strains were isolated from 187 samples and majority of them were Acinetobacter spp. followed by Klebsiella pneumoniae with 32.9% and 25.1%, respectively. 68.8% of isolates were multidrug resistant (MDR) and Acinetobacter spp. constituted 85.4%. ESBL, AmpC β-lactamase, and MBL were detected in 35 (25%), 51 (37.2%), and 11 (36.7%) isolates, respectively. Pseudomonas spp. (42.8%) were the predominant ESBL producer while Acinetobacter spp. were the major AmpC β-lactamase producer (43.1%) and MBL producer (54.5%).

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Bacteriological Profile of Tracheal Aspirates of the Patients Attending Neuro-hospital Nepal

Cited by 13 publications

References 13 publications

Multi-Drug and Pan-Drug Resistant Pseudomonas aeruginosa: A Challenge in Post- Antibiotic Era

Multi-Drug and Pan-Drug Resistant Pseudomonas aeruginosa: A Challenge in Post- Antibiotic Era

Nosocomial Isolates and Their Drug Resistant Pattern in ICU Patients at National Institute of Neurological and Allied Sciences, Nepal

β-Lactamase-Producing Multidrug-Resistant Bacterial Pathogens from Tracheal Aspirates of Intensive Care Unit Patients at National Institute of Neurological and Allied Sciences, Nepal

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