Browsing by Author "Raghubanshi, Bijendra Raj"
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Publication Meropenem Resistance among Acinetobacter Positive Clinical Samples in a Tertiary Care Centre in Nepal: A Descriptive Cross-sectional Study Authors(Nepal Medical Association, 2021) Sharma, Nisha; Thapa, Bibechan; Acharya, Ashirbad; Raghubanshi, Bijendra RajAbstract: Introduction: Antimicrobial-resistant Acinetobacter species are implicated in a variety of infections including nosocomial bacteraemia, secondary meningitis, and urinary tract infections. Carbapenem including meropenem-resistant Acinetobacter is recognized as one of the most difficult antimicrobial resistant gram-negative bacilli to control and treat. It was classified as an urgent threat by Centers for Disease Control and Prevention in 2019 Antibiotic Resistance Threats Report. This study was carried out to determine the prevalence of meropenem resistance among acinetobacter positive clinical samples in a tertiary care centre. Methods: A descriptive cross-sectional study was carried out in microbiology department of Clinical Laboratory Services among Acinetobacter positive clinical samples of a tertiary care center in Nepal. The culture and sensitivity reports of various clinical samples from April 2018 to April 2020 which were positive for Acinetobacter species were taken from hospital records section. Convenience sampling was done. Meropenem-resistant Acinetobacter samples were studied. Ethical approval was received from Institutional Review Committee (Ref No. 076/77/40). Analysis of data was done using Statistical Package for the Social Sciences version 26. Point estimate at 95% Confidence Interval calculated with ferquency. Results: Out of 121 Acinetobacter isolates, prevalence of meropenem-resistant Acinetobacter was reported in 93 (76.9%) at 95% Confidence Interval (69.39-84.40). Among the meropenem-resistant Acinetobacter samples, most of the samples were collected from the sputum 70 (75.2%) followed by blood 8 (8.6%). Conclusions: High prevalence of meropenem-resistant Acinetobacter species in our hospital setting is alarming. In addition, there is emergence of resistance against even the last resort drugs which is creating a treatment crisis.Publication Prevalence of Enteric Fever Pathogens Isolated from Blood Culture at a Tertiary Care Centre(Nepal Medical Association, 2021) Manandhar, Ruchee; Raghubanshi, Bijendra Raj; Neupane, Sweekrity; Lama, RajniAbstract: Introduction: Typhoid fever and paratyphoid fever commonly called as enteric fever is a life-threatening illness caused by Salmonella serotype Typhi and Salmonella serotype Paratyphi, respectively. It is a major public health issue in underdeveloped and developing countries. The aim of the study is to find out the prevalence of enteric fever pathogens in blood culture of patients attending a tertiary care centre. Methods: A descriptive cross-sectional study was conducted in 3483 blood samples of patients attending a tertiary care centre, with the history and symptoms suspicious of enteric fever during one year period from mid-September 2019 to mid-September 2020 after ethical approval from the institutional review committee. Isolates were identified by standard microbiological methods and tested for in vitro antibiotic susceptibility by modified kirby-bauer disc diffusion method. The obtained data was entered and analyzed in WHONET 5.6 program, point estimate at 95% was calculated along with frequency and proportion for binary data. Results: In our study, enteric fever pathogens were isolated from 18 (0.51%) blood samples. Out of which, Salmonella Paratyphi A was isolated from 10 (8.19%) and Salmonella Typhi was isolated from 8 (6.55%) blood samples. Other serotypes were not isolated. Antimicrobial susceptibility test showed that salmonella species that was isolated were sensitive to most of the drugs. Conclusions: Prevalence of enteric fever pathogens was lesser compared to other studies. Varying degrees of antibiotic resistance among isolated enteric fever pathogens necessitates continuous surveillance of the susceptibility patterns. Prudent use of antimicrobials, active infection control practices and stringent antibiotic policy should be implemented to prevent emergence of antibiotic resistance and future outbreaks.