Browsing by Author "Yadav, Poonam"
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Publication Carbapenem-Resistant Gram-Negative Bacterial Infections at a Tertiary Health Care Center in Nepal: An Observational Study(Nepal Medical Association, 2025) Konwar, Dimpi; Chaudhary, Navin Kumar; Yadav, PoonamAbstract Introduction: Carbapenems are last-resort antibiotics and are considered the drugs of choice for infections caused by multi-drug-resistant bacteria. During the last several years, there has been an alarming global increase in the detection and spread of Carbapenem-resistant organisms among gram-negative bacteria. Therefore, the main objective of this study is to determine Carbapenem-resistant gram-negative bacterial infections. Methodology: A descriptive cross-sectional study was performed. Ethical approval was granted by the Institutional Review Committee (Reference number: CMC-IRC/080/081-071). A total of 3149 non-repeated, different clinical specimens were collected, from November 2023 to February 2024, processed aseptically under the standard protocol of the American Society for Microbiology (ASM), and screened according to the Antibiotic sensitivity pattern. The analysis of the results was performed using Microsoft Excel and manual calculations. Results: Out of 3149 samples, 361 had culture-positive. Among 361 isolates, 316 were Gram-negative bacteria, among the specimens, 83 (26.26%) were identified as Carbapenem-resistant gram negative bacteria. Within this group, Acinetobacter baumannii was present in 37 (44.57%) cases, followed by Escherichia coli with 20 (24.09%), Klebsiella pneumoniae with 19 (22.89%), Stenotrophomonas maltophilia with 3 (4.81%), and Pseudomonas aeruginosa and Klebsiella aerogenes, each with 2 (2.40%) cases. The most effective antibiotics against Carbapenem-resistant Enterobacteriaceae included Colistin and Fosfomycin, whereas Carbapenem-resistant non-fermenter included Colistin and Tigecycline. Conclusions: Among Carbapenem-resistant Organisms, Acinetobacter baumannii was most prevalent. The results revealed a significant proportion of infections resistant to commonly used antibiotics, highlighting an alarming trend in antibiotic resistance.Publication Multidrug-Resistance and Biofilm Formation among Acinetobacter baumannii Isolated from Clinical Specimens(Nepal Health Research Council, 2024) Yadav, Poonam; Mishra, Shyam Kumar; Shrestha, Sreska; Sah, Ranjit; Rai, Junu Richhinbung; Kattel, Hari Prasad; Sharma, Sangita; Willcox, MarkBackground: Acinetobacter baumannii has emerged as a problematic pathogen due to its ability to become resistant to antibiotics and form biofilms. The aim of this study was to explore antibiotic resistance and biofilm formation, and examine any correlation between these in Acinetobacter baumannii isolates. Methods: This was a cross-sectional study conducted at the 750-bed Tribhuvan University Teaching Hospital in Nepal. Identification and antibiotic sensitivity of Acinetobacter baumannii isolates were performed following American Society for Microbiology guidelines. Different ?-lactamases were detected by standard phenotypic tests. The microtiter plate method was used to screen strains of their ability to form biofilms. Results: Out of total 18,343 clinical samples processed, 4,249 (23.1%) showed bacterial growth. A. baumannii comprised of 4.7% of the total bacterial growth. Multidrug-resistant (MDR) was exhibited by 97.5% of Acinetobacter baumannii isolates. All multidrug-resistant Acinetobacter baumannii isolates were resistant to cephalosporins and carbapenems; however, they were sensitive to polymyxins. Only few isolates showed sensitivity to sulbactam-containing antibiotics (15.4-29.2%), fluoroquinolones (1.0-7.2%), aminoglycosides (2.6-5.6%), and cotrimoxazole (4.1%). Extended-spectrum-beta-lactamase (ESBL), metallo-beta-lactamase (MBL), Klebsiella pneumoniae carbapenemase (KPC) and AmpC production were found in 54.9%, 73.3%, 41.5% and 14.9% isolates, respectively. Among all tested isolates, 192 were able to produce biofilms, with 83.1% being classified as strong biofilm producers. Those strains that were resistant to gentamicin were more likely to produce biofilms (P<0.05). ESBL, MBL, KPC and AmpC were seen in 51.8%, 71.6%, 43.8% and 16.0% of strong biofilm producers respectively. Conclusions: Only polymyxins were effective against Acinetobacter baumannii. Carbapenemase producers were generally strong biofilm producers, and gentamicin resistant strains were more likely to produce biofilms. The findings of this study may help to understand antibiotic-resistance mechanisms and provide valuable information in the treatment of MDR Acinetobacter baumannii infections. Keywords: Acinetobacter baumannii, biofilm, carbapenemase; multidrug-resistant.