Browsing by Author "Pradhan, Shanti"
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Publication Inducible Clindamycin Resistant Staphylococcus aureus among Patients Attending Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2021) Pradhan, Shanti; Regmi, Sanjib Mani; Shrestha, NabinaAbstract: Introduction: Staphylococcus aureus, a superbug, resistant to multiple antibiotics led to growing interest in the usage of macrolide-lincosamide-streptogramin B antibiotics, which are now rapidly developing resistance. This study aims to find the prevalence of inducible clindamycin-resistant Staphylococcus aureus among obtained clinical samples from in-patient and out-patient departments of a tertiary care center. Methods: This is a descriptive cross-sectional study done in clinical samples from the in-patient and out-patient departments of a tertiary care center from September 2020-May 2021. Ethical clearance was taken from the Institutional Review Committee (Ref: 068/2077/2078). Staphylococcus aureus were isolated and antibiotic susceptibility tests were performed by disc diffusion method. Inducible clindamycin and methicillin resistance Staphylococcus aureus were detected using D-test and cefoxitin disc according to Clinical and Laboratory Standards Institute guidelines. Convenient sampling was done and the data was analyzed using Statistical Package for Social Sciences version 20. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Results: Among a total of 141 Staphylococcus aureus isolated, the prevalence of inducible clindamycin resistant phenotype was 41 (29.1%) (21.6-36.59 at 95% Confidence Interval). Whereas, 30 (21.3%) were constitutive clindamycin resistant. The inducible 28 (47.5%) and 19 (32.2%) constitutive clindamycin resistance was higher among methicillin-resistant Staphylococcus aureus. Conclusions: The frequency of inducible clindamycin resistance among methicillin resistant Staphylococcus aureus was high, which alarms the use of macrolide-lincosamide-streptogramin B antibiotics in Staphylococcus aureus infections. Hence, D-test should be performed to detect inducible clindamycin resistance in routine testing to prevent treatment failure.Publication Scrub Typhus among Febrile Patients Admitted to the Department of Medicine in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2023) Shrestha, Sanjeeb; Pradhan, Shanti; Shrestha, Niranjan; Karn, MiteshAbstract Introduction: Scrub typhus is an acute febrile illness caused by obligate intracellular bacteria of the family Rickettsia after an incubation period of 6-21 days. The disease may lead to several complications such as acute hepatitis, sepsis, myocarditis, respiratory distress and disseminated vasculitis if not treated properly. The aim of the study was to find out the prevalence of scrub typhus among febrile patients admitted to the Department of Medicine in a tertiary care centre. Methods: This descriptive cross-sectional study was conducted among febrile patients admitted to the Department of Medicine in a tertiary care centre from 12 November 2020 to 11 May 2023 after obtaining ethical approval from the Institutional Review Committee (Reference number: 26/076-077). All patients with acute febrile illness from 17 years to 70 years were included. Patients with an acute febrile illness diagnosed with other infections such as dengue, leptospirosis, typhoid, brucellosis, malaria, and COVID-19 were excluded. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results: Among 640 patients presenting with acute febrile illness, 38 (5.94%) (4.11-7.77, 95% Confidence Interval) patients were diagnosed to have scrub typhus. Among 38 patients, 2 (5.26%) patients suffered from acute hepatitis, and 1 (2.63%) each suffered from sepsis, myocarditis, disseminated vasculitis and respiratory distress. Conclusions: The prevalence of scrub typhus among patients admitted to the Department of Medicine was found to be slightly higher than in other studies done in similar settings.