High MDR and ESBL Producing Escherichia coli and Klesbiella pneumoniae from Urine, Pus and Sputum Samples.

Aims: This study was done to assess the prevalence of multidrug resistance and extended spectrum β-lactamase producing E. coli, K. pneumoniae in urine, pus and sputum. Place and Duration of Study: This study was done to assess the prevalence of MDR and ESBL producing E. coli and Klebsiella in urine, pus and sputum from March 2013 to April 2014 at KIST Medical College, Lalitpur, kathmandu, Nepal. Methodology: E. coli and K. pneumoniae were isolated from urine, pus and sputum samples in KIST Medical College, Lalitpur, Nepal. Antibiotic susceptibility test was performed by using disk diffusion method. MDR isolates which were suspected as ESBL producers were confirmed by using double disk synergy test and combined disk diffusion test for same isolates. Results: Out of 580 urine samples, (87/580) 15% showed significant growth of E. coli and K. pneumoniae while in 97 pus and 124 sputum (16/221) 7% showed significant growth of E. coli and K. pneumoniae. From the sputum among 9 isolates, 3 were E. coli and 6 were K. pneumoniae whereas in pus among 7 isolates, 6 were E. coli and one was K. pneumoniae. Out of E. coli (77) isolates from urine, (74/77) 96.10% were MDR and of K. pneumoniae (10) isolates from urine 90% were MDR. Among E. coli (74) MDR isolates 52/74 (70.27%) were ESBL producers whereas all MDR K. pneumoniae isolates from urine were ESBL producers. All the isolates of E. coli and K. pneumoniae from pus and sputum were MDR which were resistant to tested third generation cephalosporins. Among the isolates E. coli (55.55%) and K. pneumoniae (42.85%) isolates were ESBL producers. Conclusions: The high prevalence of MDR E. coli and K. pneumoniae was observed in urine, pus and sputum. The resistance pattern was alarmingly higher to all the antibiotics used except imipenem and amikacin. The prevalence of ESBL was higher so necessary step should be taken to prevent the spread and emergence of resistance.

Study of beta lactamase activity of Staphylococcus aureus isolated from healthy nasal carriers and hospital isolates.

Staphylococcus aureus (n=84) isolated from the nostrils of a healthy population from Kathmandu and from the infectious cases (n=100) from Tribhuvan University Teaching Hospital, Kathmandu, Nepal were tested from May 1996 to March 1997 in Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal by microbiological and chemical methods to find out their beta lactamase activity. Among the healthy population, in domiciliary conditions 21.4% of the isolates were found beta lactamase producers. The occurrence of beta lactamase producing S. aureus was greater among female (27.0%) than among male (17.0%), however it was not significant (X2 = 1.2309, P > 0.05). The occurrence of the same was observed high among 40 and above age groups (66.7%) and 0-9 age group (60.0%), however no association with any particular age group was observed (X2 = 16.8674, P > 0.05). The b lactamase activity of S. aureus hospital inpatients isolates was 75.0% showing high occurrence of b lactamase activity in hospital isolates compared to S. aureus isolates from healthy carriers (X2 = 52.4113, P < 0.001). No association of beta lactamase positive hospital isolates with gender (X2 = 0.2158, P > 0.05) and age group (X2 = 1.5522, P > 0.05) was observed. This study shows that the prevalence of beta lactamase positive S. aureus was greater in hospital cases than in nasal carriers in domiciliary condition indicating the requisition of further study in this field.