NepMed Repository :: Browsing by Author "Banjara, Megha Raj"

Browsing by Author "Banjara, Megha Raj"

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Antibiotic Susceptibility of Staphylococcus Aureus with VanA and MecA Genes
(Nepal Health Research Council, 2023) Ghimire, Lata; Banjara, Megha Raj; Abdulla, Abdelkodose MH
Abstract Background: Staphylococcus aureus (S.aureus) is an emerging antibiotic resistant bacterium responsible for various infections in human. Resistance to methicillin and vancomycin are of prime concern in S. aureus. The study aims to determine the minimum inhibitory concentration (MIC) of Vancomycin and evaluate the existence of mecA and vanA genes, associated with antibiotic resistance. Methods: Clinical specimens from three Kathmandu hospitals were processed and S. aureus was identified using conventional microbiological procedures. MRSA was phenotypically identified with cefoxitin (30µg) disc diffusion, while vancomycin susceptibility was assessed using the Ezy MICTM stripes. The mecA and vanA genes were detected by polymerase chain reaction (PCR). Results: Out of 266 S. aureus samples from various clinical specimen subjected for analysis, 77 (28.9%) were found methicillin-resistant (MRSA) and 10 (3.8%) were observed vancomycin-resistant (VRSA). Vancomycin resistant isolates showed a significant correlation between resistance to ampicillin, chloramphenicol, and cefoxitin. The mecA gene was found in 39 of the MRSA isolates, having 50.64% of MRSA cases, while the vanA gene was detected in 4 of the VRSA cases, constituting 40% of VRSA occurrences. Conclusions: The strains with higher vancomycin minimum inhibitory concentration values (? 1.5 ?g/ml) displayed increased resistance rates to various antibiotics compared to strains with lower minimum inhibitory concentration values (< 1.5 ?g/ml). The presence of vanA genes was strongly associated (100%) with vancomycin resistance, while the 10.3% mecA gene was identified from MRSA having resistance towards vancomycin also. Keywords: Methicillin resistance; minimum inhibitory concentration; staphylococcus aureus; vancomycin resistance. Author Biography Megha Raj Banjara, Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal
Decadal Analysis of ESBL-Escherichia coli Antibiotic Resistance Patterns in Urine Samples from Nepal: A Systematic Review and Meta-Analysis
(Nepal Health Research Council, 2023) Chhetri, Bibek Rana; Thapa, Rajat; Banjara, Megha Raj
Abstract Background: This systematic review aimed to determine the antimicrobial resistance pattern of the extended-spectrum ?-lactamases producing Escherichia coli (ESBL-EC) in urine samples in Nepal. Methods: Systematic literature review was conducted to locate all articles reporting ESBL-EC in urine samples published between January 2012 to December 2022. The Egger’s weighted regression analysis was done to assess the publication bias. A random-effects model was used to calculate the pooled prevalence and corresponding 95% confidence interval due to significant between-study heterogeneity. The strength of correlation between multidrug resistance and ESBL production in E.coli strains was determined using Pearson’s correlation coefficient. The data were analyzed using R-language 4.2.2. software. Results: The combined prevalence of E.coli in urine samples was found to be 14 % (95% CI, 11-18), while the overall pooled prevalence of ESBL E.coli and MDR E.coli were 30% (95% CI, 20-42) and 70% (95% CI, 38-90) respectively. A strong positive correlation of 0.99 (95% CI, 0.89-1.0) was found between ESBL production and MDR among E.coli isolates. Imipenem was the drug of choice against ESBL-E.coli in urine specimens. Conclusions: Our analyses showed the overall ESBL-EC and MDR-EC burden in Nepal is considerably high. Likewise, the study also infers an increasing trend of antibiotic resistance pattern of ESBL-EC in urine samples. Keywords: ESBL-E.coli; multi-drug resistance; Nepal; urine.
Efficacy of Native Bacillus thuringiensis against Mosquito Vector
(Nepal Health Research Council, 2023) GC , Ganga; Parajuli, Kshama; Gautam, Ishan; Banjara, Megha Raj; Ghimire, Prakash; Rijal, Komal Raj
Abstract Background: Larval source management is an effective measure to control mosquito-borne diseases. Bacillus thuringiensis produces specific insecticidal crystal proteins toxic to mosquito larvae. In many parts of the South East Asian region, Bacillus thuringiensis is used for larval source management. In Nepal, larvicidal Bacillus thuringiensis is not available. The study aims to isolate larvicidal Bacillus thuringiensis from soil samples of Nepal to control mosquitoes. Methods: Native Bacillus thuringiensis was obtained from soil samples by the acetate selection method. It was identified by observing crystal protein with Coomassie Brilliant Blue stain in a light microscope. The mosquito larvae were collected from different breeding habitats. A preliminary bioassay was performed by inoculating three loopful of 48 hours culture of spherical crystal protein producing Bacillus thuringiensis in a plastic cup containing 25 larvae and 100 ml of sterile distilled water. The cup was incubated at room temperature for 24 hours to observe the mortality of larvae. Further selective bioassay was performed with the isolate which showed 100% mortality, as described above in four replicates along with the negative and positive control. Results: Out of 1385 Bacillus thuringiensis obtained from 454 soil samples, 766 (55.30%) were spherical crystal protein producers, among them, a single strain (14P2A) showed 100% mortality against mosquito larvae. The lethal concentration doses required to kill 50% and 90% of the larval population were 32.35 and 46.77 Parts per million respectively. Conclusions: The native Bacillus thuringiensis produces the crystal protein effective in killing mosquito larvae. The native Bacillus thuringiensis should be included as a tool to control mosquito-borne diseases in Nepal. Keywords: Bacillus thuringiensis; mosquito; Nepal; tool.
Epidemiological Characteristics of Hepatitis C Patients Attending a Tertiary Care Hospital
(Nepal Health Research Council, 2024) Kattel, Hari Prasad; Sharma, Sangita; Alfsnes, Kristian; Pathak, Rahul; Rijal, Komal Raj; Ghimire, Prakash; Andreassen, Ashild K; Banjara, Megha Raj
Background: Hepatitis C infection is a major public health concern in Nepal. Epidemiological information on hepatitis C virus along with the status of co-infection with hepatitis B virus and human immunodeficiency virus is essential to controlling the hepatitis C burden. The objective of this study was to determine the sero-prevalence of hepatitis C virus infections, proportions of co-infections with human immunodeficiency virus and hepatitis B virus, and identify the demographic characters, and routes of transmission. Methods: A cross-sectional study was conducted from December 2019 to February 2024 at Tribhuvan University Teaching Hospital. The serological tests were performed by enzyme-linked immunosorbent assays from 25133 patients’ serum in four years. Results: The sero-prevalence of hepatitis C virus -infected patients was 0.8% (211/25133). Among them, 6.6% (14/211) were co-infected with human immunodeficiency virus and 1.4% (3/211) with hepatitis B virus. Among 211 hepatitis C virus patients, 174 (82.5%) were male, 156 (73.9%) were young aged 15–47 years with various professions, 167 (79.1%) were literate, and almost one-third of the patients (33.2%, 70/211) were regular alcoholics. Needle sharing among intravenous drug users (45.5%, 96/211) and sexual intercourse (28%, 59/211) were the most common modes of transmission. Conclusions: Although the prevalence of hepatitis C infections is less than 1%, it is more common among young male intravenous drug users. Awareness of the spread of hepatitis C infections among this population needs to be emphasized to control hepatitis C in Nepal. Keywords: characters; co-infection; hepatitis C, sero-prevalence.
Extended Spectrum Beta Lactamase Escherichia Coli in Bagmati River, Kathmandu Valley
(Nepal Health Research Council, 2023) Ghimire, Bindu; Pokherel, Muna Kumari; Banjara, Megha Raj; Rijal, Komal Raj; Ghimire, Prakash
Abstract Background: Antimicrobial resistance organisms in the peripheral communities of an environment can be predicted by the presence of extended-spectrum beta-lactamase Escherichia coli in that environment. The close connectivity between humans and water sources can facilitate the entry of antimicrobial resistant organisms into the human ecosystem. The aim of this study was to assess beta lactamase producing Escherichia coli from Bagmati river within Kathmandu valley. Methods: In the year 2020, a cross-sectional study was conducted on water samples collected from 66 locations along the Bagmati River. Coliforms were isolated by five tubes dilution method and identified by cultural and biochemical tests. Further Escherichia coli was isolated in eosin methylene blue agar at 44.5 ?C. Antibiotic susceptibility test was performed by Kirby Bauer disk diffusion methods. Beta lactamase gene types were detected by using conventional multiplex polymerase chain reaction. Results: A total of 615 bacterial isolates were identified among which 39 % (n=241) were Escherichia coli. Extended spectrum beta lactamase producing Escherichia coli was confirmed in 16.6 % (40/241) of total Escherichia coli isolates. Among 66 sites this isolate was detected in 26 (40 %) sampling sites excluding upstream regions. All the Escherichia coli isolates were multidrug resistance showing higher percentage (>99 %) of resistant for penicillin, tetracycline and erythromycin antibiotics. There were significant differences in resistance rate for cefotaxime and ceftazidime by extended spectrum beta lactamase producing and non-producing Escherichia coli (p<0.05). Conclusions: Presence of multidrug resistance extended spectrum beta lactamase producing Escherichia coli in river streams suggests the chances of circulating within river system and hence transmitting in human community. Key words: Bagmati river; drug resistance; escherichia coli; human.
Multidrug resistant Escherichia coli isolated at National Public Health Laboratory, Nepal
(2025) Acharya, Jyoti; Shrestha, Anjana; Rijal, Nisha; Jha, Runa; Rijal, Komal Raj; Sharma, Supriya; Banjara, Megha Raj; Ghimire, Prakash
Background: Antimicrobial resistance in Escherichia coli is mostly associated with ß-lactamases and carbapenemases enzyme production resulting in treatment challenges. This study was conducted with the aim to detect and characterize antimicrobial resistance in E. coli isolates. Methods: A cross-sectional study was conducted during 2018-2022, at National Public Health Laboratory where the clinical specimens (24636) received were processed for identification and characterization of antimicrobial resistance following conventional & advanced methods. Antibiotic susceptibility tests were performed by Modified Kirby Bauer disc diffusion and Minimum inhibitory concentrations using VITEK2 compact (Biomeriux). The isolates were tested for extended-spectrum ?-lactamases and Carbapenemase production following Clinical Laboratory Standards Institute guidelines. Results: Bacterial growth was observed in 9% (2166/24636) of the specimens, of which 44% (959) were E. coli. Among the 959 E. coli isolates, 320 were reconfirmed with VITEK-MS (Biomeriux). Phenotypic multi-drug resistance was observed in 75% (240/320) of the isolates with 62% (197/320) extended-spectrum ?-lactamases, 12% (39/320) AmpC-ß-lactamase, 10% (31/320) serine carbapenemases and 7% (22/320) Metallo-ß-lactamase while 3% (9/320) produced three types of enzymes. The extended-spectrum-?-lactamase producing E. coli were sensitive to Tigecycline (100%), Amikacin (92%), Imipenem (87%), and Meropenem (84%). Carbapenemase producers were sensitive to Tigecycline (100%), with 61% to Amikacin. Extensive-drug resistance was observed in 2% (7/320) of the isolates, with Colistin resistance in one. Conclusions: The findings highlight alarmingly high antimicrobial resistance in E. coli posing significant challenges in treatment. Early detection of multi-drug resistant isolates in healthcare settings is crucial to combat antimicrobial resistance. Keywords: ?-lactamase; carbapenemases; extensive-drug resistance; metallo-ß-lactamase; multidrug resistance

Browsing by Author "Banjara, Megha Raj"

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