Browsing by Author "Sah, Anil Kumar"
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Publication Detection of blaoxa-23 Gene from Carbapenem-resistant Acinetobacter Baumannii(Nepal Health Research Council, 2022) Neupane, Laxmi; Sah, Anil Kumar; Rayamajhee, Binod; Pokhrel, Anil; Singh, AnjanaAbstract Background: Antibiotic resistance is a great concern for public health and Acinetobacter baumannii-associated infections are increasing in many parts of the world, including Nepal. However, limited data is available on the prevalence of A. baumannii harboring blaOXA-23 from Nepal. Methods: A hospital-based cross-sectional study was designed to detect the blaOXA-23 gene from carbapenem-resistant A. baumannii isolates in Nepal. A total of 380 clinical specimens were collected and processed following standard microbiological procedures. Antibiotic susceptibility test was performed as per the protocol of the Kirby-Bauer disk diffusion technique and the CLSI guidelines, while screening of carbapenemase production was assessed by the Modified Hodge Test using meropenem (10µg) disc. The presence of the blaOXA-23 gene in carbapenemase-positive A. baumannii was confirmed by PCR. Results: Among 380 specimens analyzed, 210 (55.3%) samples were positive for bacterial growth, where 33(15.7% of total growth) of the isolates were A. baumannii, and most of them were isolated from the ICU patients (20/33, 60.6%) and sputum (16/33, 48.5%). Thirty-two isolates (97%) were colistin sensitive, while only four (12.1%) isolates were sensitive to meropenem and imipenem. Twenty-three (69.7%) of A. baumannii were carbapenemase positive as revealed by the Modified Hodge Test test, and 19 of them (57.6% of total A. baumannii) harbored the blaOXA-23 gene. Conclusions: A high prevalence of the blaOXA-23 gene among carbapenem-resistant A. baumannii isolates were found. Systematic network surveillance should be established to check the spread of such isolates, especially in the intensive care units of tertiary care hospitals in Nepal. Keywords: Acinetobacter baumannii; antibiotic-resistant; blaOXA-23; carbapenemase; NepalPublication 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.Publication Postherpetic Psoriasis: A Rare Case Report Authors(Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON), 2025) Shrestha, Samir; Sah, Anil Kumar; Khadka, Varsha; Sitaula, Sabina; Gurung, KushalAbstract: Wolf’s isotopic response describes the phenomenon where a new, different skin disorder occurs at the site of a previously healed skin lesion. The most common primary and secondary diseases are herpes zoster and granuloma annulare, respectively. Psoriasis vulgaris is rare as a secondary disease, with only two cases reported. Here, we report another rare case of psoriasis vulgaris following a herpes zoster.