Browsing by Author "Rayamajhi, Heleena"
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Publication Antimicrobial Sensitivity among Bacterial Isolates from Sputum Samples in a Tertiary level Hospital(Institute of Medicine, Tribhuvan University, 2024) Kaundinnyayana, Sammodavardhana; Chaudhary, Raina; Khadka, Anjan; Bhatta, Sabita; Rayamajhi, Heleena; Sharma, ManojAbstract: Introduction Emergence of antimicrobial resistance is a huge challenge in management of pneumonia especially health care associated ones. Culture and sensitivity test of the bacteria from sputum samples is not only useful for rational treatment of respiratory bacterial infections of individual cases but also for surveillance of changing sensitivity status of prevalent organisms. The aim of this study was to find the bacterial sensitivity pattern from the sputum samples and endotracheal aspirates. Methods This cross-sectional study was conducted in Shree Birendra Hospital, Kathmandu, Nepal. Standard guideline was followed for sputum culture and identification of the bacterial isolates. The antimicrobial susceptibility test was conducted using the Kirby-Bauer disc diffusion technique. Every bacterial isolate's sensitivity was studies and noted. Results The culture positivity rate was 9.87% (99/1003). Predominant isolates were gram-negative bacteria (97.4%). Pseudomonas spp. was the most frequent isolate (31%). Among the all isolates, 48.1% of Pseudomonas spp., 81.5% of Klebsiella pneumoniae, and 60% of Escherichia coli isolates showed meropenem resistance. Imipenem and meropenem resistance was observed in 91.7% of the isolates of Acinetobacter spp. Rate of resistance to carbapenems i.e. imipenem and meropenem was higher in comparison to rate of resistance to aminoglycosides in all of the gram-negative isolates. Conclusion The isolates belonging to Enterobacterales and the Acinetobacter spp. have been found to have high incidence of resistance to carbapenems in comparison to other groups of antibacterial agents.Publication Evaluation of the Prescription Pattern of Antimicrobial Agents in Hospitalised Paediatric Patients in a Tertiary Care Hospital of Kathmandu, Nepal(Nepal Paediatric Society (JNPS), 2018) Khadka, Anjan; Rayamajhi, Heleena; Shrestha, ShovaAbstract Introduction: Infectious diseases are one of the most frequent reasons for hospital admission for children and antimicrobials are commonly used to treat them. There is higher prevalence of irrational prescriptions of antimicrobials in such population. This study was conducted to survey the pattern of antimicrobial prescription in Paediatric inpatient. Material and Methods: This was retrospective, descriptive, observational study. The data was collected from prescription records. The paediatric population included in the study was categorised into three age groups. A total of 87 prescriptions were studied and the information was recorded in performa. Data were recorded in MS Excel and Graph Pad Prism version 6 was used for analysis. Results: The number of male child was outnumbered by female child. The average age of the patient on antimicrobial prescription was 5.34 ± 2.18 years. The mean duration of hospital stay was 6.17 ± 2.01 days. The common indications for antimicrobial prescriptions were upper respiratory tract infections, diarrhoeal illness, urinary tract infections, enteric fever, etc. The antimicrobials prescription rate was 1.33. Oral route was found to be commonly used than parenteral route. The generic prescription rate was 33.6%. The most common drug prescribed was ceftriaxone followed by amoxicillin + clavulanic acid, ciprofloxacin, metronidazole and amikacin. The 62.5% of antimicrobials were prescribed from National Essential List of Medicines. Conclusion: This study highlights the prescription pattern of antimicrobial agents in hospitalised Paediatric population in a tertiary care hospital.