Prevalence of carbapenem resistant bacterial strains isolated from different clinical samples: study from a tertiary care hospital in Kathmandu, Nepal

Karn, Sitesh; Pant, Narayan Dutt; Neupane, Sanjeev; Khatiwada, Saroj; Basnyat, Shaila; Shrestha, Basudha

doi:10.3126/jbs.v3i1.16846

Cited by 19 publications

(29 citation statements)

References 25 publications

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“…(54.54%) whereas lowest from P. vulgaris (7.69%). These results were less than outcomes of previous studies (Karn et al 2016) A (Dalela 2012) study showed that imipenem is the most active drug for the treatment of infections which are caused by ESBL producers, followed by Amikacin which is similar to our fi nding. 7.48% isolates were found to be MBL producers which is higher than Mishra et al 2012 (1.3%) and lesser than Haider et al 2014 (17.93%) highest MBL producer being Pseudomonas aeruginosa (Mishra et al 2012) and ( Haider et al 2014).…”

Section: Methodscontrasting

confidence: 86%

Prevalence of Extended Spectrum Beta Lactamases (ESBL) and Metallo Beta Lactamases (MBL) Mediated Resistance in Gram Negative Bacterial Pathogens

Pathak¹,

Jaishi

Yadav

et al. 2018

TU J. Microbiol.

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Objectives: This study was conducted to determine the prevalence of multi-drug resistance (MDR) along with Extended Spectrum β-lactamase (ESBL) and Metallo β-lactamase (MBL) producing gram negative bacterial isolates among the patients attending Shahid Gangalal National Heart Centre, Kathmandu, Nepal.Methods: This cross-sectional study was carried out from June to December; 2016. Altogether 977 clinical specimens were processed for analysis of bacteriological profile and the isolates were identified by culture, morphological and biochemical tests. Antibiotic susceptibility testing of the isolates was performed by Kirby Bauer disc diffusion methods following Clinical and Laboratories Standard Institute guideline and the isolates were tested for ESBL and MBL by combined disk method.Results: out of 977 clinical specimens, 254 (25.99%) were found to be gram negative bacterial isolates, among them Klebsiella pneumoniae 83 (32.67%) was the most predominant organism followed by E. coli 51 (20.07%), Pseudomonas aeruginosa 36 (14.17%), K. oxytoca 32 (12.59%), Proteus mirabilis 13 (5.11%) and P. vulgaris 13 (5.11%), Acinetobacter spp. 11 (4.33%), Citrobacter spp. 10 (3.93%) and Enterobacter spp. 5 (1.96%) respectively. 83 (32.67%) isolates were found to be MDR, 38(14.96%) were positive for ESBL while 19 (7.48%) were MBL producer.Conclusion: The determent drug resistance among ESBL and MBL producers, reflect the extensive use of antibiotics possessing difficulties in therapeutic potions in hospital setting which might be overcome by proper microbiological analysis of pathogenic isolates and judicious use of antibiotics for emergence of resistance strains.

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Section: Methodscontrasting

confidence: 86%

Prevalence of Extended Spectrum Beta Lactamases (ESBL) and Metallo Beta Lactamases (MBL) Mediated Resistance in Gram Negative Bacterial Pathogens

Pathak¹,

Jaishi

Yadav

et al. 2018

TU J. Microbiol.

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“…Studies from other hospitals have reported MBL as the most common carbapenamase among the non-fermentative Gram negative bacteria. 27,28 The prevalence of carbapenamase has been reported from 4% to 74%. [29][30][31][32] Recent studies from other hospitals of Nepal reported the prevalence of carbapenam resistance from 4.5%-86.4%.…”

Section: Discussionmentioning

confidence: 99%

“…[29][30][31][32] Recent studies from other hospitals of Nepal reported the prevalence of carbapenam resistance from 4.5%-86.4%. 21,27 This reflects that the prevalence varies from hospital to hospital within a country. Colistin and tigecycline are effective against carbapenamase producing strains of Acinetobacter species with low level of resistance.…”

Section: Discussionmentioning

confidence: 99%

Burden of multidrug resistant respiratory pathogens in intensive care units of tertiary care hospital

et al. 2019

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Background: Lower respiratory tract infections are one of the most common infections among the patients in Intensive Care Units (ICUs). Admission in ICUs and use of life supporting devices increase the risk of infection with multidrug resistant pathogens. Aims and Objectives: This study was aimed to determine the prevalence and antibiograms ofthe bacterial pathogens causing lower respiratory tract infectionsamong patients of ICUs. Materials and Methods: A total of 184 specimens from patients admitted in ICUswith lower respiratory tract infections were included in this study. Isolation, identification and antibiotic susceptibility testing of the isolates was performed by standard microbiological techniques. Carbapenamase detection was performed by modified Hodge test method.Detection of metallo beta lactamase (MBL) was tested by imipenem and imipenem/EDTA disc. Detection of Klebsiellapneumoniaecarbapenamase (KPC) was performed by imipenem and imipenem/phenyl boronic acid. Results: Out of 184 samples, 131 showed significant growth of bacterial pathogens. Acinetobacter species (42.6%), Staphylococcus aureus (16.9%) and Pseudomonasaeruginosa(13.9%)were the three most common isolates. Out of 22 imipenem resistant isolates of Acientobacter species, 9 were KPC producer, 4 were MBL producers and 3 isolates were positive for MBL and KPC both. Among the Acinetobacter species, 5.1% isolates were resistant to tigecycline and colistin. One isolate of Pseudomonas aeruginosa was positive for MBL. Conclusions:High prevalence of multidrug resistant bacteria in ICUs was recorded. Gram negative bacilli were predominantly associated with LRTI among ICU patients;Acinetobacterspecies being most common isolate. Detection of carbapenamase among the Acinetobacterand emergence of tigecycline resistancelimits the therapeutic options.Regular monitoring of such resistant isolates would be important for managing infection control in critical units.

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“…In Nepal, previous studies have reported the prevalence of carbapenem resistance in Gram-negative bacteria. [15][16][17][18][19] Studies have reported varying prevalences of carbapenem resistance in bacteria in different settings, including 7.4% in Model Hospital, Kathmandu, 15 12.6% in the Human Organ Transplant Center, Bhaktapur, 16 7.6% in Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, 18 and 27% in Kathmandu University Teaching Hospital, Sinamangal, Kathmandu. 17 Another similar study, conducted in Bharatpur, Hospital, Chitwan, reported a 40% prevalence of carbapenem-producing Enterobacterales; 41.3% E. coli and 57.1% K. pneumoniae isolates.…”

Section: Introductionmentioning

confidence: 99%

Detection of OXA-48 Gene in Carbapenem-Resistant Escherichia coli and Klebsiella pneumoniae from Urine Samples

Gurung¹,

Kafle²,

Dhungel³

et al. 2020

IDR

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Introduction: Resistance to carbapenem in Gram-negative bacteria is attributable to their ability to produce carbapenemase enzymes. The main objective of this study was to detect the presence of blaOXA-48 genes in carbapenem-resistant uropathogenic Escherichia coli and Klebsiella pneumoniae isolated from urine samples from patients attending Alka Hospital, Jawalakhel, Lalitpur, Nepal. Methods: A total of 1013 mid-stream urine samples were collected from patients with suspected urinary tract infection (UTI) between April and September 2018. The identified isolates underwent antibiotic susceptibility testing using the modified Kirby-Bauer discdiffusion method. Phenotypic carbapenemase production was confirmed by the modified Hodge test, and the blaOXA-48 gene was detected using conventional polymerase chain reaction. Results: Out of 1013 urine samples, 15.2% (154/1013) had bacterial growth. Among the isolates, 91.5% (141/154) were Gram-negative bacteria, and E. coli was the most common bacterial isolate (62.9%; 97/154), followed by K. pneumoniae 15.6% (24/154). Among 121 bacterial isolates (97 E. coli isolates and 24 K. pneumoniae isolates), 70.3% (52/121) were multidrug-resistant E. coli and 29.7% (22/121) were multidrug-resistant K. pneumoniae. In addition, 9.1% (11/121) were carbapenem resistant (both imipenem and meropenem resistant). Development of multidrug resistance and development of carbapenem resistance were significantly associated (p<0.05). Of the 11 carbapenem-resistant isolates, only seven were carbapenemase producers; of these, 28.6% (2/7) were E. coli, 72.4% (5/7) were K. pneumoniae and 42.8% (3/7) had the blaOXA-48 gene. Of the three bacterial isolates with the blaOXA-48 gene, 33.3% (1/3) were E. coli and 66.7% (2/3) were K. pneumoniae. Conclusion: One in ten isolates of E. coli and K. pneumoniae were carbapenem resistant. Among carbapenem-resistant isolates, one-third of E. coli and two-thirds of K. pneumoniae had the blaOXA-48 gene. OXA-48 serves as a potential agent to map the distribution of resistance among clinical isolates.

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Prevalence of carbapenem resistant bacterial strains isolated from different clinical samples: study from a tertiary care hospital in Kathmandu, Nepal

Cited by 19 publications

References 25 publications

Prevalence of Extended Spectrum Beta Lactamases (ESBL) and Metallo Beta Lactamases (MBL) Mediated Resistance in Gram Negative Bacterial Pathogens

Prevalence of Extended Spectrum Beta Lactamases (ESBL) and Metallo Beta Lactamases (MBL) Mediated Resistance in Gram Negative Bacterial Pathogens

Burden of multidrug resistant respiratory pathogens in intensive care units of tertiary care hospital

<p>Detection of OXA-48 Gene in Carbapenem-Resistant <em>Escherichia coli</em> and <em>Klebsiella pneumoniae</em> from Urine Samples</p>

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