Browsing by Author "Sharma, Manisha"
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Publication Antimicrobial Susceptibility Pattern of Acinetobacter calcoaceticus-Acinetobacter baumannii Complex Isolated from Sputum in a Tertiary Care Hospital(Institute of Medicine, 2019) Sapkota, Jyotshna; Sharma, Manisha; Shrestha, Deepti; Jha, BeenaABSTRACT Introduction Acinetobacter calcoaceticus-Acinetobacter baumanni (ACB) complex is one of the commonest cause of hospital acquired and ventilator associated pneumonia. Multidrug resistant Acinetobacter species have become a matter of huge concern. This study was done to find out the antibiotic susceptibility pattern of Acinetobacter calcoaceticus-Acinetobacter baumanii complex from sputum samples. Methods This descriptive cross-sectional study was carried out in Clinical Microbiology laboratory from July 2018 to Jan 2019 after ethical approval. Acinetobacter calcoaceticus-Acinetobacter baumannii complex was identified on the basis of its microscopy and morphological characteristics followed by biochemical tests. Antibiotic sensitivity test of isolated pathogens was done using Muller Hinton Agar by Kirby-Bauer method. Results Of the 384 culture positive sputum specimen, 76 (19.80%) were Acinetobacter calcoaceticus-Acinetobacter baumannii complex. Most of the isolates were resistant to commonly used antibiotics, 72.36% of the isolates were multidrug resistance and 3.95% isolates were resistant to tigecycline. Conclusion This study provides valuable information regarding prevalence of Acinetobacter calcoaceticus-Acinetobacter baumannii complex from sputum specimen. The alarming number of Multidrug resistance isolates is worrisome finding. Antibiotics like Tigecycline and Colistin which is still sensitive to isolates should be cautiously used only in MDR cases. Keywords: Acinetobacter, ACB complex, antibiotic resistance, MDR, NepalPublication Onychomycosis among Clinically Suspected Cases Attending the Dermatology Out-patient Department of a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2021) Jha, Beena; Sharma, Manisha; GC, Sagar; Sapkota, JyotshnaAbstract: Introduction: Onychomycosis is a fungal disease of the nail apparatus caused by dermatophytes, non-dermatophytes and yeasts. Although onychomycosis is rarely life threatening, its high incidence and the associated morbidity makes it an important public health problem. This study was aimed to find the prevalence of onychomycosis among clinically suspected patients attending the outpatient department of Dermatology and Venereology. Methods: A descriptive cross-sectional study was done in a total of 200 clinically suspected cases of onychomycosis attending the Dermatology outpatient department of a tertiary care hospital within the period of one year from 1st September 2019 to 31st August 2020. Ethical approval (Reference: 150320196) was taken and convenience sampling was done. Data were analyzed using Statistical Package for Social Sciences version 19. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of 200 clinically suspected cases prevalence of onychomycosis was found to be 40 (20%) (Confidence Interval = 19.94-20.06) by both direct microscopy and culture. Onychomycosis was commonest among age group of 21-40 years and more predominant among male patients 60 (65.21%). The fingernails were frequently involved i.e., 58 (63%) cases followed by toenails 34 (21%). Dermatophytes were the most common type of fungal infection accounting for 25 (62.5%). Conclusions: The study highlighted dermatophytes as the most common clinical pattern of onychomycosis and Trichophyton rubrum as the most common aetiological agent causing onychomycosis.Publication Prevalence of Methicillin Resistant Staphylococcus aureus Nasal Colonizers among Basic Science MBBS and BDS Students of Kathmandu Medical College(Nepal Medical Association, 2021) Sharma, Manisha; Jha, Beena; Bhatt, Chandra PrakashAbstract: Introduction: Methicillin-Resistant Staphylococcus aureus exhibit multiple drug resistance phenotypes. Colonizers harboring Methicillin-Resistant Staphylococcus aureus are often associated with its outbreaks in both hospital and community settings. This study was done to determine the prevalence of nasal carriage rate of Methicillin-Resistant Staphylococcus aureus among basic science MBBS and BDS students of Kathmandu Medical College. Methods: A descriptive cross-sectional study was done in Kathmandu Medical College from March 5 to June 5 2020. Ethical clearance was obtained from the Institutional Review Committee with reference no. 040320201. A convenient sampling method was used, and the sample size was calculated with a prevalence of 50%. Two hundred students studying MBBS and BDS were enrolled. The nasal swab was collected and processed using standard microbiological methods. The data obtained were computed and analyzed using Statistical Package for Social Sciences 16.0 Version. Results: Among 200 participants, 9 (4.5%) were found to be nasal carriers of Methicillin-Resistant Staphylococcus aureus. Conclusions: Colonization of anterior nares by Methicillin-Resistant Staphylococcus aureus in apparently healthy individuals is a cause of concern. Education regarding Methicillin-Resistant Staphylococcus aureus, its carrier and significance, and its screening must be included early on in MBBS and BDS.Publication Profile and Antibiotic Susceptibility Pattern of Bacterial Isolates from Mobile Phones of Healthcare Workers in a Tertiary Care Centre of Nepal(Institute of Medicine, 2020) Sapkota, Jyotshna; Jha, Beena; Mishra, Bhavesh; Shrestha, Deepti; Barakoti, Achut; Sharma, ManishaABSTRACT Introduction: Nosocomial infection is a serious problem worldwide. Healthcare workers mobile phones may act as vehicle for nosocomial infections. Mobile phones are rarely cleaned and healthcare workers frequently use them thorough out their time in hospitals. The objective of this study is to determine the rate of contamination of mobile phones, prevalent microorganisms and their antibiotic sensitivity pattern. Methods: The descriptive cross-sectional study was carried out in Clinical Microbiology laboratory from July 2019 to September 2019 after ethical approval. Samples were collected aseptically by rolling sterile swabs over the exposed surfaces of the mobile phones and inoculated on the agar plates and incubated aerobically. After incubation, plates were examined for growth. Bacteria were identified by standard microbiological procedure and antibiotic sensitivity test of isolated pathogens was done using Muller Hinton Agar by Kirby-Bauer method. Statistical analysis was done by Excel 2018. Results: Of the 198 mobile phones sample cultures, 112 (56.6%) samples showed 7 different types of bacteria. Mixed growth was observed in 3 mobile phones and total of 115 bacterial isolates were identified. Staphylococcusspecies (74.7%) were predominant organism followed by Acinetobacter spp, Klebsiella pneumoniae, E. coli, Citrobacter and Pseudomonas aeruginosa. Total 37.5% of Staphylococcus aureus were methicillin-resistant Staphylococcus aureus (MRSA). Conclusion: Mobile phones may have potential pathogenic microorganisms on their surface and can act as vector in spread of infectious agents in hospital settings. It is recommended to disinfect mobile phones regularly and to implement hand washing practices and regulations around the use of mobile phones in hospital settings. Keywords: Acinetobacter species, mobile phones, MRSA, nosocomial infections, Staphylococcus speciesPublication Speciation and Fluconazole Susceptibility of Candida Isolates from Clinical Samples in a Tertiary Hospital in Nepal(Institute of Medicine, Tribhuvan University, 2024) Sapkota, Jyotshna; Aryal, Kiran; Adhikari, Ram Prasad; Khadka, Sushila; Pandey, Ritu; Khanal, Laxmi Kant; Shrestha, Deepti; Sharma, ManishaAbstract: Introduction Candida species, commonly present as human commensals, are notable opportunistic pathogens responsible for superficial and invasive infections, particularly in hospitalized patients. This study aimed to characterize the distribution and antifungal susceptibility patterns of Candida species isolated from various clinical specimens at a tertiary care hospital in Nepal. Methods A descriptive cross-sectional, laboratory-based study was conducted in the Clinical Microbiology Laboratory of Nepal Medical College Teaching Hospital between July 2023 and June 2024. Clinical specimens yielding Candida species over the one-year period were included. Growth on Sabouraud dextrose agar was analyzed for colony morphology, Gram staining, germ tube production, and urea hydrolysis. Speciation of Candida isolates was performed using CHROMagar. Additionally, fluconazole susceptibility testing was conducted following Clinical and Laboratory Standards Institute guidelines. Results A total of 72 Candida isolates were identified from samples such as sputum, urine, and high vaginal swabs. Candida albicans was the most prevalent species 45 (62.5%), followed by non-albicans Candida (NAC) species, including C. glabrata 14 (19.4%), 9 C. tropicalis (12.5%), and 4 C. parapsilosis (5.6%). Fluconazole resistance was observed in 22.2% of total isolates of Candida, with C. glabrata exhibiting the highest resistance 12, (86%), whereas 4 (9%) of C. albicans demonstrated resistance to it. Conclusion The findings highlight a shift in epidemiology toward NAC species and raise concerns about rising fluconazole resistance. These results underscore the need for routine species identification and antifungal susceptibility testing to guide effective management strategies. The study advocates for antifungal stewardship programs and ongoing surveillance to address emerging resistance trends in Candida infections.Publication Vitamin D Deficiency among Blood Transfusion-Dependent Beta Thalassemia Children Admitted to Tertiary Level Pediatric Hospital in Nepal: A Descriptive Cross-Sectional Study(Nepal Medical Association, 2024) Shrestha,Anil Kumar; Sherpa, Sangay Chultim; Gyawali, Bindu; Sharma, Manisha; Adhikari, Santosh; Shrestha, Suchitra; Bhattarai, Susan; Thapa, Sagar; Sharma, Devashish; Paudel, Prajwal; Gyawali, SushilAbstract Introduction: Children with beta thalassemia are on regular blood transfusions, which could result in iron deposition in the liver causing decreased synthesis of Vitamin D-25OH. There are limited publications on the association of Vitamin D deficiency with blood transfusion-dependent thalassemia in the Nepalese population. This study aims to determine the prevalence of Vitamin D deficiency among blood transfusion-dependent beta-thalassemia patients. Methods: This was a descriptive cross-sectional study conducted among beta-thalassemia major patients under 15 years of age, receiving regular blood transfusion, from July 17, 2022, to July 16, 2023, after attaining ethical approval from Ethical Review Committee, (reference number 155). Data were collected using convenience sampling, and descriptive analyses were performed using Microsoft Excel and Statistical Package for Social Sciences (SPSS) 2024. Results: A total of 127 blood transfusion-dependent beta-thalassemia major patients were included in the study, of whom 82 (64.56%) were female. Among these patients, 104 (81.88%) were aged between 5 and 14 year. Among 127, 41 (32.28%) had Vitamin D insufficiency, and 31 (24.40%) had Vitamin D deficiency. There were 12 (9.44%) underweight children. Conclusions: Vitamin D deficiency was seen in more than half of the children with blood transfusion dependent beta thalassemia major.