Browsing by Author "Kandel, Ramesh"
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Publication Antimicrobial Resistance among Older Patients Attending Rapti Academy of Health Sciences: A Retrospective Study(Rapti Academy of Health Sciences (RAHS), 2025) Kandel, Ramesh; Pokhrel, Subrata; Sharma, DamodarAbstract: Introduction: Antimicrobial resistance (AMR) is an escalating global health concern, particularly in developing countries like Nepal. Older adults are disproportionately affected due to immunosenescence, frequent hospital admissions, and repeated antibiotic exposure. However, limited region-specific data exist on AMR patterns among older adults in Nepal. This study aims to evaluate the microbiological profile and antibiotic resistance patterns, including the prevalence of multidrug-resistant organisms (MDROs), in individuals aged 60 years and above in a tertiary care center in Lumbini Province. Methods: A retrospective descriptive analysis was conducted on 495 clinical culture samples obtained from patients aged ≥60 years over a one-year period. Data were retrieved from microbiology records and analyzed using SPSS version 16. Descriptive statistics were used to determine organism prevalence, sample sources, and resistance patterns. MDROs were defined as resistance to at least one antimicrobial in three or more drug classes. Results: The mean age of patients was 71.8 years(SD±8.0), with females comprising 77% of the sample. Urine was the most common specimen (94.3%). Escherichia coli(59.6%) was the predominant isolate, followed by Klebsiella spp.(8.9%) and Acinetobacter spp.(5.9%). MDROs accounted for 62% of isolates. E. coli and Klebsiella exhibited high resistance to penicillins(85–92%) and cephalosporins(70–77%). Acinetobacter demonstrated extensive resistance across multiple antibiotic classes. Conclusion: This study reveals a high burden of MDROs among older adults, highlighting the urgent need for targeted antimicrobial stewardship, infection control, and development of localized treatment protocols to combat AMR in this vulnerable population.