Helicobacter pylori colonization in Nepal; assessment of prevalence and potential risk factors in a hospital-based patient cohort.

BACKGROUND: Helicobacter pylori, a gram-negative bacterium, can cause gastritis, peptic and duodenal ulcers. It is considered an important public health problem for both developed and developing world. This bacterium is classified as the class 1 carcinogen because it can cause cancer. METHODS: A hospital based study was conducted at Chitwan Medical College Teaching Hospital (CMCTH) from May to October 2014. Stool samples were collected from the suspected patients and were subjected to detection of the H. pylori stool antigen (HpSAg) following the procedures recommended by the manufacturer. A standard questionnaire on the potential risk factors was also designed and completed. RESULT: HpSAg was detected in 16 % of suspected patients. The children up to 10 years of age were found to be highly infected (36 %). The patients living in urban area were found more susceptible to develop H. pylori infection (P < 0.05). Tea drinking and repeated eating habit (more than twice a day) were listed as the important factors that can limit the H. pylori infections significantly (P < 0.05). CONCLUSION: In this hospital based study, a significant rate of prevalence was evaluated. However, we recommend a community based extensive study to reveal the real scenario of H. pylori infection in Nepalese populations.

Childhood septicemia in Nepal: documenting the bacterial etiology and its susceptibility to antibiotics.

Introduction. Children are among the most vulnerable population groups to contract illnesses. The varying microbiological pattern of septicemia warrants the need for an ongoing review of the causative organisms and their antimicrobial susceptibility pattern. Therefore, the objective of this study was to document the bacterial etiology of childhood septicemia and its antibiotic susceptibility profile. Methods. Cross-sectional type of study in 1630 suspected patients was conducted at CMCTH from January 2012 to December 2013. Blood samples were collected aseptically for culture. The organisms grown were identified by standard microbiological methods recommended by American Society for Microbiology (ASM) and subjected to antibiotic susceptibility testing by modified Kirby-Bauer disk diffusion method. Methicillin resistance was confirmed using cefoxitin and oxacillin disks methods. Results. Septicemia was detected in 172 (10.6%) cases. Among Gram-positive organisms, coagulase negative staphylococci (CoNS) were leading pathogen and Acinetobacter spp. were leading pathogen among Gram-negative isolates. Vancomycin, teicoplanin, and clindamycin were the most effective antibiotics against Gram-positive isolates while amikacin was effective against Gram-positive as well as Gram-negative isolates. Methicillin resistance was detected in 44.4% of Staphylococcus aureus. Conclusions. This study has highlighted the burden of bacterial etiology for septicemia among children in a tertiary care center of central Nepal.