Browsing by Author "Tuladhar, NR"
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Publication Antimicrobial susceptibility pattern and serotyping of Streptococcus pneumoniae isolated from Kanti Children Hospital in Nepal(Kathmandu University, 2010) Rijal, B; Tandukar, S; Adhikari, R; Tuladhar, NR; Sharma, PR; Pokharel, BM; Gami, FC; Shah, A; Sharma, A; Gauchan, P; Sherchand, JB; Burlakoti, T; Upreti, HC; Lalitha, MK; Thomas, K; Steinhoff, MAbstract Background: Invasive pneumococcal disease is a significant cause of morbidity and mortality worldwide and it is a major cause for childhood deaths in Nepal. Objectives: The aim of this study was to establish the antimicrobial susceptibility pattern of Streptococcus pneumoniae and perform serotype responsible for pneumococcal disease in Nepal. Materials and methods: All together 3774 children from 2 to 60 months who fulfilled the enrollment criteria for suspect of bacterial pneumonia, sepsis or meningitis were enrolled for etiologic studies of severe illness. During the study period 60 isolates of Streptococcus pneumoniae were isolated and the antimicrobial susceptibility testing and serotyping were performed. Results: The study showed that 24 (52.17%) isolates were resistant to Cotrimoxazole, 3 (6.5%) isolates were intermediately resistant to Penicillin but no Penicillin resistant strains were isolated. The 1 (2.17%) isolate was recorded as Erythromycin and Chloramphenicol resistant and only 1 (2.17%) isolate was found intermediately resistant to Cefotaxime. Of the 60 isolates, serotyping result was available only for 46 isolates. The most common serotypes were serotype 1 (27. 65%) followed by serotype 5 (19.14%) and serotype 4 (8. 5%) respectively followed by serotype 39, 23F, 7F, 19B, 12A, 14, 18F, 6B, 32, 16, 19F and 25F. Conclusions: Alarming level of Cotrimoxazole resistance demands revision of pneumonia treatment policy in Nepal and rising tendency of other drug resistance against Streptococcus pneumoniae showed use of these drugs for the treatment of meningitis, pneumonia and other serious infections needs extended research. The common serotype 1, 5 and 4 need to be incorporated in pneumococcal vaccine to immunise children in Nepal. Key words: Antimicrobial susceptibility, Streptococcus pneumoniae, Serotyping, NepalPublication Bacterial Conjunctivitis and Use of Antibiotics in Dhulikhel Hospital - Kathmandu University Hospital(Kathmandu University, 2011) Sthapit, PR; Tuladhar, NR; Marasini, S; Khoju, U; Thapa, GABSTRACT Background Acute Infective Conjunctivitis may be due to viral or bacterial infection; though it is usually self limiting, topical antibiotics are often prescribed for rapid recovery. Objectives This study aims to find out prevalence of bacterial infection among cases of acute infective conjunctivitis and to determine their in-vitro antibacterial susceptibilities to commonly used antibacterial agents and to find out whether the rampant use of topical antibiotics are at all necessary or justified. Methods A prospective analytical study conducted over a period of two years on clinically diagnosed cases of Acute Infective Conjunctivitis. Isolation and identification of microorganisms by culture and antimicrobial susceptibility test were done on conjunctival swabs from 65 patients. Results A total of 65 patients were included where children (one month to 10 years old) accounted for the commonest age group (35.4%).On Gram’s Stain, 90.8% were negative for pus cells or micro organisms. Gram positive cocci were found in 6.2% of cases. On culture, bacterial growth was seen in 11 cases (18.9%) among which Streptococcus pneumonia was seen in seven cases (10.8%).The analysis on in-vitro susceptibility testing showed that Chloramphenicol and Gentamicin were the most sensitive (78.6% of samples) drugs for conjunctivitis. Conclusion Ophthalmic antibiotics should be prescribed judiciously in acute infective conjunctivitis even for suspected bacterial cases; since it is found to resolve spontaneously without any serious complications. Chloramphenicol and Gentamicin are drugs of choice if at all required. Key Words acute infective conjunctivitis, bacterial conjunctivitis, chloramphenicol, gentamicin