Browsing by Author "Gami, FC"
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Publication Antimicrobial susceptibility pattern and serotyping of Streptococcus pneumoniae isolated from Kanti Children Hospital in Nepal(Kathmandu University, 2010) Rijal, B; Tandukar, S; Adhikari, R; Tuladhar, NR; Sharma, PR; Pokharel, BM; Gami, FC; Shah, A; Sharma, A; Gauchan, P; Sherchand, JB; Burlakoti, T; Upreti, HC; Lalitha, MK; Thomas, K; Steinhoff, MAbstract Background: Invasive pneumococcal disease is a significant cause of morbidity and mortality worldwide and it is a major cause for childhood deaths in Nepal. Objectives: The aim of this study was to establish the antimicrobial susceptibility pattern of Streptococcus pneumoniae and perform serotype responsible for pneumococcal disease in Nepal. Materials and methods: All together 3774 children from 2 to 60 months who fulfilled the enrollment criteria for suspect of bacterial pneumonia, sepsis or meningitis were enrolled for etiologic studies of severe illness. During the study period 60 isolates of Streptococcus pneumoniae were isolated and the antimicrobial susceptibility testing and serotyping were performed. Results: The study showed that 24 (52.17%) isolates were resistant to Cotrimoxazole, 3 (6.5%) isolates were intermediately resistant to Penicillin but no Penicillin resistant strains were isolated. The 1 (2.17%) isolate was recorded as Erythromycin and Chloramphenicol resistant and only 1 (2.17%) isolate was found intermediately resistant to Cefotaxime. Of the 60 isolates, serotyping result was available only for 46 isolates. The most common serotypes were serotype 1 (27. 65%) followed by serotype 5 (19.14%) and serotype 4 (8. 5%) respectively followed by serotype 39, 23F, 7F, 19B, 12A, 14, 18F, 6B, 32, 16, 19F and 25F. Conclusions: Alarming level of Cotrimoxazole resistance demands revision of pneumonia treatment policy in Nepal and rising tendency of other drug resistance against Streptococcus pneumoniae showed use of these drugs for the treatment of meningitis, pneumonia and other serious infections needs extended research. The common serotype 1, 5 and 4 need to be incorporated in pneumococcal vaccine to immunise children in Nepal. Key words: Antimicrobial susceptibility, Streptococcus pneumoniae, Serotyping, NepalPublication Postinfective Glomerulonephritis (PIGN) in Children Attending a Tertiary Care Centre in Nepal(Nepal Paediatric Society (JNPS), 2014) Poudel, DR; Basnet, S; Gami, FCAbstract: Introduction: Post infectious glomerulonephritis (PIGN) is one of the common paediatric kidney disease in developing countries. This study was undertaken to describe the common clinical features, biochemical findings and complications in children with PIGN. Materials and Methods: This was a retrospective descriptive study in which 30 patients admitted with a diagnosis of PIGN at Tribhuvan University Teaching Hospital (TUTH) in a six month period (July 2014 to Dec 2014) were included. Hospital medical records were reviewed for the data collection. Results: Out of 30 patients, 24 (80%) were between 5 to 15 years of age (mean age of 11.5±3.3) with male to female ratio of 2.3:1. Pedal oedema and hypertension were the clinical features seen in 29 (97%) and 28 (93%) patients respectively. Hypocomplementemia was found in 29 (97%) patients. Recent past history of sore throat seen in 10 (33%) patients and skin lesions in 12 (40%). The complications noted were congestive cardiac failure in 5 (17%) patients, rapidly proliferative glomerulonephritis in 3 (10%) and encephalopathy in 1(3%). Conclusion: The most important clinical and biochemical profile observed in nepalese children with PIGN are the hypertension, pedal edema and hypocomplementemia.Publication Streptococcus pneumoniae among children with clinical meningitis in Nepal(Institute of Medicine, 2015) Sherchan, JB; Tandukar, S; Shrestha, L; Rai, GK; Sharma, A; Gami, FC; Rijal, B; Sherchand, JB; Ohara, HAbstract Introduction: Invasive bacterial disease is a significant cause of morbidity and mortality worldwide and it is a major cause of childhood deaths in Nepal. Streptococcus pneumoniae is responsible for invasive and non-invasive pneumococcal diseases worldwide, such as pneumonia, bacteremia and meningitis. The aim of the study was to isolate, identify and determine antimicrobial susceptibility pattern of Streptococcus pneumoniae along with use of rapid immunochromatographic test “Binax NOW”, to detect antigen for diagnosis of bacterial meningitis. Methods: The study was carried out from October 2013 to September 2015 in Children’s Hospital, Teaching Hospital-Department of Child Health and Public Health Research Laboratory, Institute of Medicine, Kathmandu, Nepal. Cerebrospinal fluid sample from 339 suspected cases of meningitis from children below 15 years of age were examined for identification by Gram staining, Culture and by Binax Now test. The identification of bacteria was done following standard method recommended by American Society for Microbiology. Antibiotic sensitivity testing was done by modified Kirby- Bauer disk diffusion method. Results: Of total 339 suspected cases, 24(7.08%) bacterial meningitis was detected by Gram staining and culture methods whereas BinaxNow method detected 28(8.26%). On the basis of age, the highest numbers of the positive cases were found in the age group between 0-23 months (9.30%) followed by age group 49-60 months (8.16%) Conclusions: In conclusion, a significant rate of bacterial meningitis was found in this study prompting concern for national wide surveillance. Keywords: Children, Meningitis, S. pneumoniae, Nepal