Browsing by Subject "Multi drug resistant"
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Item Comparative Antibiogram Typing of Gramnegative Isolates from Hospital Environment and Clinical Samples(Department of Microbiology, 2011) Panta, KrituCross infection through hospital environment has been major challenge to controlnosocomial infection. This has been worse with the emergence of multidrug resistantstrains. The present study was conducted to correlate gram negative bacteria in hospitalenvironment and clinical samples, to understand possibility of nosocomial infection. The study was conducted for a period of six months during which gram negative isolatesfrom 269 samples of hospital environment (air sample, surface swab and hand swab fromhealthcare workers) and 1110 clinical samples (urine, blood, pus, catheter tips, sputum etc)were identified by conventional microbiological method and antibiogram was performed byKirby-Bauer disc diffusion method andNCCLSguidelines.Bacterial isolates obtainedfrombothsamples were tested for their relatednessbased on their resistivity pattern amongthe tested antibiotics. Of the total environmental samples212samples were found to be positive and total of 183gram negative isolates were obtained and of the total clinical samples(1110)159 isolateswere obtained. Of the total gram negative isolates 84.2% (154/183)Acinetobacter spp.,8.2% (15/183) E. coli,7.7% (14/183)Klebsiella spp. was isolated from environmentalsample. And 3.1% (5/160)Acinetobacter spp., 67.5% (108/160) E. coli, 8.8% (14/160)Klebsiellaspp.was isolated fromclinicalsamples. Analysis ofMDRisolatesrevealed 70.8% (109/154)Acinetobacterspp.and80.0% (4/5)inclinical isolates were found to be MDR. Similarly86.6% (13/15)E. coli isolates isolatedfrom environment sample and61.1% (66/108)clinical isolates were found to be MDR. Incase of Klebsiella spp.100%(14/14)environmental isolates and42.9 %(6/14)clinicalisolates were found to be MDR. Antibiotyping showed single antibiogram type wasidentical in both the sample type in case of Acinetobacterspp. and Klebsiella spp. whilesuchcorrelation wasnot establishedamongthe isolates ofE. coliin both sample types. Keywords:-Environment, clinical, gram negative, MDR,antibiogram typing, antibiogram typeItem ENUMERATION AND DETECTION OF ANTIBIOTIC SUSCEPTIBILITY PATTERN OF COLIFORM BACTERIA FROM MILK SAMPLES IN KATHMANDU.(Amrit Campus, 2022-08-08) SURAJ, CHAULAGAINThe presence coliforms and their resistance in milk is the big issue in present time. Milk is an excellent source of nutrients and also serves as a good medium for the growth of milk-borne pathogens. Cross-sectional study was conducted to assess and compare microbial quality of raw milk and pasteurized milk and also determine antimicrobial susceptibility patterns of coliforms from the milk samples. For this, 30 milk samples (15 raw and 15 pasteurized milk) were collected from different locations of Kathmandu district. Starch adulteration test and MBRT were done. TCC, FCC for each sample were determined by pour plate technique and interpretated with BIS guidelines (1992), DFTQC guidelines and identification was done. Antibiotic susceptibility testing of isolates was carried out by Kirby Bauer disk diffusion method using 12 different antibiotics. TCC of the 12 raw samples were higher than the guideline and its FCC was also found to be higher in 9 samples. In case of pasteurized samples, TCC was higher in 6 samples and FCC in 4 samples. A total of 31 isolates, 21 from raw samples and rest from pasteurized samples were identified. Out of 31 isolates, 17 (54.84%) were identified as Klebsiella spp., 13 (41.94%) were E. coli and 1 (3.22%) was Citrobacter spp. AST of coliform isolates were 100% sensitive against TE. 96.77% of the isolates were sensitive towards NIT, PIT, COT, C and AK. Out of total, 11 (35.48%) were MDR (Multi-Drug Resistant). Among them, 7 (63.64%) were from raw samples and rest 4 (36.36%) from pasteurized samples. Although, quality of most of the samples were good as per MBRT but the presence of antimicrobial resistant bacteria and adulterants questions the overall quality ofmilk. Thus, it is concluded that the milk produced by small-scale farm from the studied area are not of good quality, caused by coliforms especially the antibiotic resistant. Therefore, such type of study for monitoring the microbial quality of milk should be done in order to safeguard the consumers. Otherwise, it will be hazardous for the consumers and can be a potential source of milk-borne infections.Item Molecular Characterization of Lytic Bacteriophage Specific to Multi Drug Resistant Bacteria and Pharmacokinetics of Phage in Biological Model(Faculty of Biotechnology, 2022) Dhungana, GunarajAvailable with full textItem Molecular Characterization of Rifampicin and/or Isoniazid Resistant mycobacterium Tuberculosis Complex(Department of Microbiology, 2012) Sharma, Bijay KumarIntroduction:The ability to rapidly and accurately detect drug resistance in Mycobacterium tuberculosis complex (MTBC) isolates is critical for the appropriate treatment of patients suffering from TB and the effectiveness ofTB control programs. Geno Type MTBDR plus will allows rapid confirmation of TB through the identification of genetic mutations associated withrifampicin and isoniazid resistance. Therefore, this study provides genetic information of isoniazid and rifampicin drug resistance TB isolates in Nepal. Objectives: To rapidly identify drug resistant TB in cultured specimen through the identification of genetic mutations associated with rifampin and isoniazid resistance in in Mycobacterium tuberculosis complex (MTBC)isolates. Methods: Fluorescence microscopy was performed on 62 suspected tuberculosis specimen followed by their culture on on Lowenstein–Jensenmedium for detection of Mycobacterium tuberculosis. Culture specimens werethen analysed for identification of rifampicin and /or isoniazid resistance using Genotype MTBDR plusassay. Results: Among the drug resistant isolates, MDR (multidrug resistance i.e.resistant to at least isoniazid and rifampicin) isolates were predominant (51%).Among all rifampicin resistant isolates, 61.76%of them had mutations in the530-533 region ofrpoBgene and was the most commonmutation observed as detected by the lack of binding to various wild type probes in the presence of D 516 V and S531 L mutation. More RIF-monoresistant strains (16.66%) had aD516V mutation(MUT1 band) compared to MDR strains (3.5%).Of all IN Hresistant strains96.96% had a mutation in the katGgene and 3.03% had amutation in the inhAgene. All isoniazid resistant strains that have mutation ininh A gene were found to be multidrug resistant. None of the strains had mutations in both thekatGand inhAgenes. S315T1 and S531L were found asthe mostcommon mutation for rifampicin and isoniazid respectively. Conclusions: Geno Type MDTBR plus assay can be effectively used for the detection of mutationsin most commongenes responsible for isoniazid and/orrifampicin resistance. Keywords: TB, Genotype MTBD Rplus, MDR, MTBC.Item A Study on Microbiology of Urinary Tract Infection at Tribhuvan University Teaching Hospital Kathmandu Nepal(Department of Microbiology, 2006) Khanal, ShovaA study was conducted among patients suspected of UTI attending outpatients departmentand hospitalized patients of Tribhuvan University Teaching Hospital, Katmandu, Nepal.The study was conducted for three months from June 2006 to August 2006. The objectivesof the study were to isolate bacteria causing UTI, to correlate bacteriuria with pyuria, todetermine antibiotic susceptibility pattern of isolated organisms and to analyze the MDRstrains. One hundred and eighty five midstream urine samples collected were investigated byconventional semi-quantitative culture technique, microscopy and antibiotic susceptibilitytest. Only 22.16% (41/185) of the samples showed significant bacterial growth. Slightly greaterprevalence of bacteriuria was found in males (24.67%) than in females (20.37%) and higherin inpatients (29.09%) than in outpatients (19.23%).Statistically it was found that there wasno significant association of significant bacteriuria in males and females (P>0.05). Similarlyassociation of presence of bacteriuria and hospitalization of patients was also found out tobe statistically insignificant (P>0.05). Status of bacteriuria was found higher in age group20-30 (19.51%) followed by 30-40 (17.07%) in female and 9.75% in 20-30 and 50-60 yearsin male patients. Eight different species of bacteria were isolated among whichEscherichia coli (65.85%)was the most predominant isolate followed byKlebsiellaspecies(K. pneumoniaeandK.oxytoca) (12.19%), Staphylococcus aureus(7.32%),Pseudomonas aeruginosa(4.88%),Streptococcus faecalis (4.88%). The other organisms isolated were Proteus vulgaris(2.44%) andEnterobacterspecies(2.44%). Predictors concerning pus cell count (5/HPF) and erythrocytes count (3/HPF) wereanalyzed to determine the positive predictive value (PPV) relation to the significantbacteriuria. PPV for pus cell count was found to be higher (54.38%) than that of RBCcount(27.27%). Gram-negative bacilli (excludingPseudomonas aeruginosa,Klebsiella oxytoca, Klebsielllapneumoniae) showed best susceptibility towards Nitrofurantoin(58.33%) followed byCeftriazone (50%) . Amikacin was also effective as Nitrofurantoin against Pseudomonasaeruginosa, K. oxytoca,andK. pneumoniae.The most effective antibiotic to overall gram-positive bacteria was found to be Novobiocin (100%) and Erythromycin (60%). Multidrug resistance was observed in 56.09% (23/41) bacterial isolates ofwhich the mostpredominant wasEcherichia coli 62.96% ( 17/27) and that inKlebsiella pneumoniaewas50%(2/4) .Item Urinary Tract Infection in Pregnant Women and Antibiotic Susceptibility Pattern of Bacterial Isolates with Reference to Extended Spectrum Beta Lactamase Producing Strains(Department of Microbiology, 2011) Thapa, RekhaThe objective of this study was to determine the prevalence of urinary tract infection among the pregnant women and antibiotic susceptibility pattern of bacterial isolates with reference to extended spectrum β-lactamase producing strains. This cross sectional study was conducted at Paropakar Maternity and Women’s Hospital,Thapathali, Kathmandu from June to December 2010 among 1720 pregnant women attending their antenatal checkup. Information regarding various characteristics was obtained and urinespecimen was processed for isolation of bacteria, performing antibiotic susceptibility test byKirby-bauer disc diffusion method and ESBL test by Double Disc Synergy Test (DDST) method. The prevalence of UTI was found to be 30.5%. Majority of the pregnant women were fromoutpatient department of hospital (65.7%), urban areas of the country (52.3%), age group 21-30years (74.3%), unemployed (73.3%), literate (88.0%), primiparous (54.3%) and second trimesterof pregnancy (48.3%). Parity, education status, occupation of pregnant women, times of bathing,history of UTI, presence of pus cells and RBC in urine was found to be the risk factors of UTIfrom both univariate and multivariate analysis. E. coli (52.0%) was found to be the mostpredominant isolate and Pseudomonas aeruginosa (0.7%) was least one. Gentamicin andamikacin were found to be the most effective antibiotics. About 72.0% of the isolates were foundto be multidrug resistant with higher rate in hospitalized patients (84.0%). About 20.0% ofE.coli and 36.4% of the Klebsiella pneumoniae were found to be the ESBL producers. There is a great need to follow strictly the hospital antimicrobial policy in order to prevent the emergence and dissemination of MDR and ESBL producing microorganisms as they are associated with the treatment failure of UTI. KEY WORDS: Pregnant women, UTI, multi drug resistant, ESBL