Browsing by Author "Rijal, KR"
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Publication Antimicrobial Resistance Pattern of Pseudomonas aeruginosa Isolates from Tertiary Care Hospitals in Kathmandu(Kathmandu University, 2023) Shrestha, PM; Kattel, HP; Sharma, S; Bista, P; Basnet, BK; Ghimire, P; Rijal, KRABSTRACT Background Antimicrobial resistance, caused by Pseudomonas aeruginosa (P. aeruginosa), poses a global health threat, limiting treatment options and increasing morbidity and mortality rates due to its intrinsic and multidrug resistance. Objective To determine the antimicrobial resistance patterns of P. aeruginosa isolates from patients visiting or admitted to tertiary care hospitals in Kathmandu. Method A cross-sectional study was conducted at Bir Hospital and Tribhuvan University Teaching Hospital (TUTH) from December 2021 to December 2022. Isolates were identified and tested for antibiotic susceptibility following standard microbiological guidelines. Result The antimicrobial resistance of 200 P. aeruginosa isolates increased from low to high levels, as per the recommended anti-pseudomonal antibiotics by the Clinical and Laboratory Standards Institute (CLSI), from 0% to 94%. piperacillin/tazobactam exhibited significantly lower resistance at 18(9%) and while considerably higher resistance was observed with ceftazidime at 188(94%) compared to different antibiotics, followed by amikacin 34(17%), imipenem 58(29%), ciprofloxacin 42(21%), aztreonam 51(25.5%), and fosfomycin 44(22%). No resistance was observed to colistin and polymyxin B. P. aeruginosa resistant to carbapenem was accounted for 33.5% of the total, and multidrug resistance categories included multidrug resistance (MDR) at 39.0%, extensively drug resistance (XDR) at 13.5%, and P. aeruginosa difficult-to-treat (DTR PA) at 4.6%. Conclusion Most of the isolates were resistant to anti-pseudomonal antibiotics; however, colistin, polymyxin B, amikacin, doripenem, piperacillin/tazobactam, and fosfomycin were effective against MDR P. aeruginosa. Regular surveillance measures are essential to manage antimicrobial resistance. KEY WORDS Antimicrobial resistance, Difficult-to-treat Pseudomonas aeruginosa, Extensively drug resistance, Multidrug resistancePublication Methicillin Resistant Staphylococcus Aureus in patients visiting Western Regional Hospital, Pokhara(Institute of Medicine, 2008) Rijal, KR; Shrestha, N; Pahari, N; Shrestha, B; Paudel, B; Nepal, A; Ghimire, P; Rijal, BAbstract Introduction: Methicillin Resistant Staphylococcus aureus (MRSA) continues to be a major cause of serious infection in hospitals and in the community worldwide. This study was performed to determine the prevalence of Methicillin resistant Staphylococcus aureus in healthy school children and patients visiting Western Regional Hospital of Pokhara. Methods: The children from three Schools namely Janapirya Higher Secondary School, Sublime School and Ratnajyoti School and patients visiting Western Regional Hospital were selected for the study. This study was conducted by The School of Pharmaceutical and Biomedical Sciences during July to November 2007. One hundred eighty four Nasal swabs were collected from the healthy school children younger than 15 years old and one hundred clinical samples such as pus, wound swabs were collected from patients attending Western Regional Hospital. Collected nasal swabs and clinical swabs were analyzed for the growth of Staphylococcus aureus on mannitol salt agar (MSA). S. aureus was isolated and identified by mannitol fermentation, coagulase positivity and DNase positivity. Antimicrobial susceptibility test was performed on Muller-Hinton agar (MHA) medium by Modified Kirby-Bauer disc diffusion method. Results: Out of 284 samples, 184 were nasal swabs, from healthy school children and 100 were clinical samples from patients attending Western Regional Hospital. Out of total nasal swabs (n=184), S. aureus was isolated from 30.97 % (n=57). Out of 57 isolates of Staphylococcus aureus, isolated from healthy school children 56.14 % (n=32) were MRSA. Out of 100 clinical samples isolated from hospital patients, S. aureus was isolated from 45% (n= 45).Out of 45 isolates of S. aureus, 75.55% (n=34) were MRSA. Prevalence of MRSA was statistically significant in clinical specimens in comparison with nasal swabs isolated from healthy school children (P < 0.05). Conclusion: This study showed a high prevalence of MRSA carriage in school children and hospital patients of Pokhara valley and this may indicate the spread of MRSA in the community. Larger community based studies and regular surveillance of MRSA are needed to assist in the development of therapeutic guidelines for MRSA. Keywords: Staphylococcus aureus, MRSA, MHA, Modified Kirby-Bauer methodPublication Soil Bacteria that Kill Mosquito Larvae(Kathmandu University, 2024) GC, G; Banjara, MR; Gautam, I; Ghimire, P; Rijal, KRABSTRACT Background To control the deadliest mosquitoes, Bacillus thuringiensis var israelensis and Bacillus sphaericus are the tools to prevent the development of adult mosquitoes by killing the larvae in different water sources. Various countries formulated Bacillus thuringiensis and Bacillus sphaericus larvicide in different forms isolated from various sources to control mosquitoes. These bacteria are nontoxic for humans and other living organisms. In Nepal, unawareness and unavailability of these isolates made us inaccessible to these tools to control mosquito vectors. To address the increasing trend of mosquito-borne diseases in Nepal these bacteria should be included as a vector control tool. Objective To isolate and test the novel bacteria Bacillus thuringiensis and Bacillus sphaericus from the soil sample of Nepal as a biological mosquito control tool. Method Soil samples collected from seven provinces of Nepal were processed by two different techniques to isolate these two bacteria. The isolates were characterized by different staining techniques, and by larvicidal bioassay against Aedes aegypti larvae. Result From 282 soil samples analyzed by the acetate selection method 846 Bacillus thuringiensis isolates were obtained producing different types of crystal protein. Among 846 isolates only one isolate showed 100% mortality against Aedes aegypti larvae. On analysis of 32 soil samples by heat shock selection method, 11 Bacillus sphaericus and 11 Bacillus thuringiensis were obtained. Only one Bacillus sphaericus showed 25% mortality against Aedes aegypti larvae. Conclusion Two different Bacillus strains obtained from the soil sample of Nepal showed 100% and mild toxicity against Aedes aegypti larvae. KEY WORDS Bacillus sphaericus, Bacillus thuringiensis, Control, Nepal, VectorPublication The pattern of anti-tuberculosis drug resistance in pulmonary tuberculosis patients(Institute of Medicine, 2005) Rijal, KR; Ghimire, P; Bam, DSAbstract Background: Tuberculosis is one of the major public health problems in Nepal.. , Drug resistant tuberculosis has posed a serious challenge in TB control program. Drug resistance tuberculosis is the most difficult for the treatment and cure of the patient. Objective: To find out the current situation of drug resistant pattern at national tuberculosis center, Nepal. Design: Central Department of Microbiology, Tribhuvan University in collaboration with NTC, STC, conducted a prospective study. Methods: One hundred ninety-nine Mycobacterium tuberculosisisolated from the sputum in national tuberculosis center (NTC) were studied to find out the drug resistant pattern by utilizing absolute concentration method. Results: Of the 199 culture positive strains were tested, 161from previously treated cases and 38 from new cases. Overall primary and acquired resistance were 36.82%and 75.05%respectively. The study showed that the Primary drug resistance (PDR) to one drug was found to be 23.67%, to two drugs was 10.52%, to three drugs was 0%, and four drugs was 2.63%where as acquired drug resistance (ADR) to one drug was 32.38%, to two drug was 19.19%, to three drugs was 11.78%, to four drugs was 11.80%. Primary and acquired multi-drug resistance (MDR)) was in 2.63% and 19.25% of the isolates respectively. Conclusion: Overall, drug resistance of M.tuberculosisis high. It is concluded that regular monitoring of MDR–TB and making policy according to research finding is necessary as it is changing every year, which helps to control MDR-TB.