Joshi, BindiraYadav, Santosh KumarHada, Manju Shree ShakyaShrestha, SabinaShrestha, Kalpana KumariShrestha, Pukar ChandraAwal, Bal Krishna2025-08-032025-08-032023https://hdl.handle.net/20.500.14572/1159Bindira Joshi Department of Pathology, Shahid Dharmabhakta National Transplant Centre, Bhaktapur, Nepal https://orcid.org/0000-0003-2541-3015 Santosh Kumar Yadav Province Public Health Laboratory, Madhesh Province, Janakpurdham, Nepal https://orcid.org/0000-0002-1392-155X Manju Shree Shakya Hada Department of Microbiology, Tri-Chandra Multiple Campus, Tribhuvan University, Kathmandu, Nepal https://orcid.org/0009-0008-8795-817X Sabina Shrestha Department of Pathology, Shahid Dharmabhakta National Transplant Centre, Bhaktapur, Nepal Kalpana Kumari Shrestha Department of Nephrology, Shahid Dharmabhakta National Transplant Centre, Bhaktapur, Nepal Pukar Chandra Shrestha Department of Transplant Surgery, Shahid Dharmabhakta National Transplant Centre, Bhaktapur, Nepal Bal Krishna Awal Infectious Diseases Unit, National Public Health Laboratory, Kathmandu, Nepal https://orcid.org/0000-0003-1052-3895Abstract Background: The intestinal colonization and transmission of antibiotic-resistant Enterobacteriales to renal transplant recipients may pose a threat to them because they are profoundly immunocompromised and vulnerable to infection. Hence, it is crucial to identify these antibiotic-resistant fecal Enterobacteriales harboring high-risk populations. The objective of this study was to determine antibiotic resistance as well as ?-lactamases production in fecal Enterobacteriales among renal transplant recipients. Methods: The stool samples, one collected from each transplant recipient, were processed for isolation and identification of Enterobacteriales and were tested for their antibiotic susceptibility, extended-spectrum ?-lactamase, and metallo-?-lactamase production by standard methods. Results: A total of 103 Enterobacteriales comprising of Escherichia coli (86.4%), Klebsiella species (11.7%), and Citrobacter species (1.9%) were isolated and more than 60% of the E. coli were found resistant to ceftazidime and ciprofloxacin and around half of the Klebsiella species were resistant to ceftazidime and fluroquinolones. The extended-spectrum ?-lactamase production was seen in 3.4% and 8.3% and metallo-?-lactamase production in 24.7% and 33.3% of E. coli and Klebsiella species, respectively. The high proportion of ?-lactamase-producers were resistant to piperacillin-tazobactam, meropenem, gentamicin, and amikacin than ?-lactamases non-producers. Conclusion: Since the antibiotic resistance is higher in fecal Enterobacteriales, each renal transplant recipient should be screened for these highly resistant intestinal colonizers after transplantation in order to prevent infections and to reduce the rate of transplant failure due to infections. Keywords: Antibiotic resistance; ?-lactamases; enterobacteriales; fecal carriage; renal transplantation. Author Biographies Bindira Joshi, Department of Pathology, Shahid Dharmabhakta National Transplant Centre, Bhaktapur, Nepal Santosh Kumar Yadav, Province Public Health Laboratory, Madhesh Province, Janakpurdham, Nepalen-USArticle