Browsing by Author "Khadka, Shusila"
Now showing 1 - 2 of 2
Results Per Page
Sort Options
Publication Ampicillinase C Beta-lactamase Producers among Isolates of Enterobacteriaceae in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Khadka, Shusila; Barakoti, Achut; Adhikari, Ram Prasad; Khanal, Laxmi Kant; Sapkota, JyotshnaAbstract Introduction: Ampicillinase C beta-lactamase-producing organisms are often resistant to multiple antimicrobial agents, and therapeutic options against these pathogens are limited. Limited information is available regarding Ampicillinase C beta-lactamase producers. The aim of this study was to find out the prevalence of Ampicillinase C beta-lactamase producers among isolates of Enterobacteriaceae in a tertiary care centre. Methods: A descriptive cross-sectional study was carried out in the Clinical Microbiology Laboratory of a tertiary care centre from May 2021 to October 2021. Ethical approval was received from the Institutional Review Committee (Reference number: 044-077/078). Isolates of Enterobacteriaceae from various clinical samples were collected by convenience sampling. Ampicillinase C screening for beta-lactamase producers among the Enterobacteriaceae isolates was done using cefoxitin (30 μg) disc. Detection of Ampicillinase C beta-lactamase producers among the screen-positive isolates was done by cefoxitin-cloxacillin double-disc synergy test. An increase in the zone size of ≥4 mm was considered as Ampicillinase C beta-lactamase producers. Point estimate and 95% Confidence Interval were calculated. Results: Among the total 481 isolates of Enterobacteriaceae, 49 (10.19%) (7.50-12.90, 95 % Confidence Interval) were detected as Ampicillinase C beta-lactamase producers among isolates of Enterobacteriaceae. Conclusions: The prevalence of Ampicillinase C beta-lactamase producers was lower than in other studies done in similar settings. Meropenem could be a drug of choice for the treatment of infections due to Ampicillinase C beta-lactamase-producing gram-negative bacteria.Publication Phenotypic and Genotypic Detection of Metallo-b Lactamase in Non-Fermenting Gram Negative Bacilli Obtained from Clinical Samples in a Tertiary Care Hospital in Nepal(Institute of Medicine, Tribhuvan University, 2025) Sapkota, Jyotshna; GC, Divya Shree; Adhikari, Ram Prasad; Khadka, Shusila; Pandey, Ritu; Sah, Anil Kumar; Khanal, Laxmi KantAbstract: Introduction Non-fermenting Gram-negative bacilli, including Pseudomonas aeruginosa and Acinetobacter baumannii, are significant nosocomial pathogens with limited treatment options due to their intrinsic and acquired resistance mechanisms. Among these, metallo-β-lactamases are of major concern which hydrolyze carbapenems and contribute to antimicrobial resistance. This study aimed to determine the prevalence of Metallo-β-Lactamase-producing non-fermenting gram negative bacilli in clinical specimens using both phenotypic and genotypic methods. Methods A descriptive cross-sectional study was conducted at Nepal Medical College Teaching Hospital from January 2024 to December 2024. A total of 16,954 clinical specimens were processed for culture and sensitivity testing. NFGNB were identified using standard microbiological methods. Antimicrobial susceptibility testing was conducted using the Kirby-Bauer disk diffusion method following Clinical and Laboratory Standards Institute guidelines. MBL production was detected phenotypically using the Imipenem-EDTA combined disc method. The presence of IMP and VIM genes was confirmed by conventional PCR. Results Among 16,954 specimens, 163 (0.96%) NFGNB isolates were identified, with Pseudomonas aeruginosa (52.1%) being the most prevalent, followed by Acinetobacter species (39.3%) and Burkholderia species (8.6%). MBL production was detected in 22 (13.5%) isolates: Pseudomonas aeruginosa (59.1%), and Acinetobacter species (40.9%). Genotypically IMP and VIM genes were found in 36.4% and 31.8% of MBL-positive isolates, respectively, while one isolate harbored both genes. Notably, 27.3% of phenotypic MBL producers tested negative for both IMP and VIM, suggesting the potential involvement of other MBL genes. Conclusion The significant prevalence of MBL-producing NLFGNB, particularly among Pseudomonas aeruginosa and Acinetobacter species, highlights a serious challenge for antimicrobial therapy and underscores an urgent need for robust infection control and antimicrobial stewardship strategies.