Bacteriological study of neonatal sepsis and antibiotic susceptibility pattern of isolates in Kathmandu, Nepal.

Bloodstream infections in neonates are life-threatening emergencies. Identification of the common bacteria causing such infections and their susceptibility patterns will provide necessary information for timely intervention. This study was done to determine the prevalence of neonatal septicaemia, identify the bacterial isolates and study their antimicrobial susceptibility pattern in neonates admitted to the neonatal intensive care unit of Nepal Medical College Teaching Hospital (NMCTH), Kathmandu, Nepal. This descriptive-analytical study was conducted in NMCTH from July 2011 to January 2012. Blood culture of all neonates who were suspected for neonatal sepsis was performed. Bacterial isolation, identification and antimicrobial susceptibility testing were done by standard microbiological method. Out of 120 neonates suspected of having neonatal sepsis, 30.8% (37/120) were blood culture positive (i.e. prevalence = 30.8%). The most common causative agents of neonatal sepsis was Staphylococcus aureus (56.8%; 21/37) followed by Klebsiella pneumoniae (21.7%; 8/37), Pseudomonas aeruginosa (13.4%; 5/37) and others. Neonatal sepsis was more frequent in male neonates (32.5%) while (26.5%) in female neonates in the ratio of 1.2:1 (p > 0.05). Neonatal sepsis was significantly higher (58.3%) in low birth weight (LBW) (< 2.5kg) neonates compared with good birth weight (GBW) (23.9%) (< 0.05). Prevalence was higher in preterm neonates (57.8%; 11/19) as compared with term-babies (25.7%) (P = 0.05). Generally, all of the isolates were sensitive to most of the antibiotics used as the first line drugs like amikacin, gentamicin, cefotaxime and ampicillin except Acinetobacter baumannii. This organisms was only sensitive towards cotrimoxazole, azithromicin, cefotaxime and ceftazidime.

Tobacco and alcohol: the relation to pulmonary tuberculosis in household contacts.

Tuberculosis is transmitted commonly by droplet nuclei and facilitated by weak immune system. Lowered immunity may be associated with cigarette smoking, tobacco chewing and alcohol consumption. The co-relationship between these all factors to TB should be explored. This study aims to detect the hidden household contacts (HC) cases early and to examine the relative contribution of tobacco and alcohol use to the risk of TB. Across-sectional study was in Dharan among HCs. From June 2009 to May 2010, 184 index cases with sputum smear positive for AFB and their 802 HCs were included. Three sputum specimens were collected from each HCs and examined microscopically for AFB detection. AFB were detected in sputum of 13 (1.6%) HCs. The association between habits (alcohol user and smoking) and TB was found except with chewing tobacco user (P > 0.05). The risk of contact TB was 4 and 8 times greater in smoker (OR = 3.94 95% CI = 1.26-12.26, P < 0.05) and alcoholic (OR = 8.23 95% CI = 2.71-24.98, P < 0.05) HCs respectively. This study has revealed smoking and alcohols as the risk factors for tuberculosis. Effective campaign to discourage use of alcohol and tobacco, and awareness programme about the mode of transmission of TB are needed in community.

Intestinal parasitic infections among patients attending Nepal Medical College Teaching Hospital, Kathmandu, Nepal.

This study was conducted to find out the prevalence of intestinal parasitic infection among patients attending Nepal Medical College Teaching Hospital, Kathmandu from July 2011 to February 2012. A total of 312 stool samples collected in a clean, dry screw capped plastic container were examined using the formal-ether concentration and sucrose-flotation techniques. Overall parasite positivity rate was 30.1% with significant difference between males (34.2%) and Female (26.3%) (p < 0.05). Out of total positive, 90.4% had single parasitism whereas 9.6% had multiple parasitism. Children aged < or = 5 years were found to be highly infected (35.8%), followed by 6-15 years (32.1%) and > 15 years old (26.9%). Rate of infection was significantly higher among patients from inside Kathmandu Valley (31.1%) than outside valley (17.4%) (p < 0.05). E. histolytica (38.5%) and Hookworm (10.6%) were the commonest protozoa and helminthes respectively. Other parasites detected were G. lamblia (26.0%), E. coli (1.0%), T. trichiura (7.7%), A. lumbricoides (6.7%), H. nana (5.8%) and Taenia species (3.8%). Out of total parasites detected, 65.4% were protozoa and 34.6% were helminthes. Positive rate was higher in Dalit (37.5%) and Aadibasi-Janjati (34.3%) than Brahman-Chhetri (22.6%) (p < 0.05).

Prevalence of intestinal worm infestations among school children in Kathmandu, Nepal.

Intestinal worm infestation is one of the major childhood health problem in Nepal. This study was done to assess the prevalence of intestinal worm infestations among school children aged 6-16 years in a public high school in Kathmandu Nepal. A total of 142 stool samples from healthy students were collected and reported following formol-ether concentration technique. The overall prevalence of intestinal worm infestation was found to be 17.6% (Boys = 22.0% vs girls = 13.5%). Children aged 6-8 years were found to be highly infected with intestinal worms (21.4%) followed by 9-12 years old (18.6%). Those between 13-16 years of age were significantly less infected (10.7%) compared to others (p < 0.05). Ova/cysts of intestinal parasites detected include Trichuris trichiura (32.0%), Ascaris lumbricoides (20.0%), Hymenolepis nana (16.0%), hookworm (8.0%) and 24.0% cases showed mixed parasitic infections.

Status of intestinal parasitosis among hospital visiting patients in Deukhury Valley, Dang, Nepal.

Intestinal parasitosis is highly prevalent among the general population in Nepal. This study aimed to assess the status of intestinal parasitosis among patients attending Deukhury Community Hospital, Lamahi, Dang, situated in the mid western region of Nepal. A total of 210 stool samples examined by direct smear technique were reported. The overall prevalence of intestinal parasitic infection was found to be 21.4% (M = 23.5% vs F = 19.3%). Children < 15 yrs age were infected more often as compared to > 60 yrs and 15-60 yrs aged people. Among adults, Entamoeba histolytica infection was found to be very high compared to high helminthic infection found among children. Finding showed that, the prevalence was significantly high (68.8%) among people having low socio-economic status compared to others (31.1%) (p < 0.05). Among various parasites detected, E. histolytica was the most common parasite (48.8%) followed by helminths, mainly Ascaris lumbricoides (31.1%), hookworm (13.3%), Trichuris trichiura (4.4%) and Taenia species (2.2%) respectively in the locality.

Prevalence of methicillin resistant Staphylococcus aureus (MRSA) among skin infection cases at a hospital in Chitwan, Nepal.

This study was carried out to see the methicillin resistance of Staphylococcus aureus isolated from patients with skin and soft tissue infection. In this study, a total of 600 S. aureus isolates isolated from 1,334 specimens from skin and soft tissue infection were included. For the screening of methicillin resistant of S. aureus (MRSA), specimens were inoculated on lipovitellin mannitol salt agar (LMSA) and MRSA were screened by testing resistance to oxacillin in AST plate following the standard bacteriological technique. The overall prevalence of MRSA was 68.0% (408/600). MRSA infection was higher among patients above 30 years of age. Tibeto-Burmans had high MRSA infection rate (72.5%) than Indo-Aryans (56.8%) and the rate was significantly higher among males (75.0%) than females (63.4%) (p<0.05). MRSA isolation rate was higher from wound (76.9%), followed by purulent exudates (67.7%) and abscesses (64.1%). The high prevalence of MRSA found in this study might be due to hospital based specimen.

Prevalence of asymptomatic bacteriuria among elderly diabetic patients residing in Chitwan.

BACKGROUND: A retrospective study was done on Asymptomatic Bacteriuria (ASB), among elderly diabetic patients residing in Chitwan, Nepal from 1st January 2006 to 12th December 2006. Diabetic patients above 40 years of age were included in this study where as below 40 years of age group were excluded. OBJECTIVE: To study the prevalence of ASB among elderly diabetic patients for the Bacteriological profile and their antibiotic susceptibility pattern. MATERIALS AND METHODS: Urine sample was collected from 636 diabetic patients above 40 years age attending College of Medical Sciences Teaching Hospital for regular blood sugar estimation. Culture and Antibiotic susceptibility test (AST) were performed using standard microbiological technique. ASB was determined as presence of > 105(5) bacteria/ml in a culture of urine sample. RESULTS: The prevalence of ASB among diabetic patients in Bharatpur was found to be 9.43% (12.07% in females and 5.08% in males). The most common bacterial isolate was Escherichia coli (41.66%). Nitrofurantoin, Cefotaxime and Chloramphenicol were the most effective drugs for the majority of isolates. CONCLUSION: The study shows necessity of regular urine culture to detect ASB, along with blood sugar estimation for diabetic patients to prevent them from further complications due to it.