Browsing by Author "Shrestha, Deepti"
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Publication Prescribing Pattern of Antibiotics among Hospitalized Patients with Urinary Tract Infection(Nepal Health Research Council, 2022) Shrestha, Deepti; Sapkota, Jyotshna; Poudel, Rekha; Gurung, Rashmi Shakya; Aryal, KiranAbstract Background: Urinary tract infection is one of the most common bacterial infections worldwide. It has become one of the most common cause for the hospitalization and sepsis. It is generally treated with antimicrobial agents and fluids. This study was conducted to study the prescribing pattern of antibiotic among hospitalized patients with urinary tract infection. Methods: A descriptive cross-sectional study was conducted in Nepal Medical College Teaching Hospital, Attarkhel, Kathmandu from January 2022 to April 2022. Patients aged 18 years or above of both sex, admitted to various departments with the provisional diagnosis of urinary tract infection prescribed with antibiotics were included in the study. Results: Out of 146 patients admitted with a diagnosis of urinary tract infection, the most commonly prescribed antibiotics during hospital stay were cephalosporin in 102 (69.9%) patients followed by combination of penicillin and beta-lactamase inhibitors (31, 21.2%) and fluoroquinolones (15, 10.3%). Ceftriaxone (78, 53.4%) alone was the most commonly prescribed antibiotic as empirical therapy followed by combination of piperacillin and tazobactam (22, 15.1%). One hundred and forty four (78.6%) patients were prescribed antibiotics from the watch group followed by the access group (21, 11.5 %). E. coli was the most common organism isolated in 29 (76.3%) patients. Conclusions: Cephalosporin was the commonest antibiotic group prescribed in hospitalized patients among which ceftriaxone was commonly prescribed as an empirical therapy. Among AWaRe classification, antibiotics from the watch group were commonly prescribed. Keywords: Antibiotics; ceftriaxone; urinary tract infectionPublication 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.