Ramesh Sharma Regmi

The emergence of co-existence of colistin and tetracycline resistance within Escherichia coli isolates in poultry and human being narrow down the effectiveness of antibiotics, alarming a big threat to human being in disease management worldwide. The problem is more severe in the developing countries like Nepal where colistin is highly used in poultry feed and drinks. A laboratory and field based cross sectional study was conducted from February 2022 to June 2022 so as to determine the trends of colistin resistance among E. coli isolates from poultry. A total of 200 samples; 50 fecal sample, 50 cloacal swab, 50 feed sample and 50 drinking water sample of five different and most affected poultry farms of Bharatpur municipality were collected and processed for isolation, identification of E. coli, and antibiotic susceptibility testing. The resistant isolates were screened for the presence of mcr-1 and tet-B gene by using conventional PCR assays. Out of 200 samples investigated, total E. coli isolates recovered was 34% (68/200). In AST, gentamycin was found to be the least effective antibiotic showing resistance to 94.1% (64/68) isolates whereas colistin was found to be the most effective antibiotic showing resistance to only 19.1% (13/68) E. coli isolates. Among 68 E. coli isolates, 83.8% (57/68) of isolates were found to be MDR, 7 (10.29%) E. coli isolates had mcr-1 gene whereas 16 (23.52%) E. coli isolates had tet-B gene. Haphazard use of antibiotic should be completely discouraged in the poultry industries.

Background: Plasmodium vivax is the predominant cause of malaria in South Asia. P. vivax cases have fallen over the past decade, but cross-border transmission remains a major challenge to elimination. Genetic data can generate valuable insights into transmission; however, until now, only low-resolution data have been available from Nepal, Bhutan and Bangladesh. We piloted high-resolution genotyping using a new microhaplotype (multiallelic) assay to monitor P. vivax transmission across borders. Methods: Genotyping was conducted using the 93-microhaplotype vivaxGEN panel on P. vivax parasites collected from patients enrolled in clinical trials in Bangladesh, Bhutan, and Nepal between 2013 and 2023. These data were compared with open-access microhaplotype and genomic data derived from Afghanistan, India, and Pakistan between 2014 and 2024. Complexity and relatedness (identity by descent [IBD]) were determined within and between countries. Results: High-quality genotyping data were generated for Nepal (n = 19), Bhutan (n = 27), and Bangladesh (n = 35); comparative data were sourced from Afghanistan (n = 159), India (n = 24), and Pakistan (n = 213). High-complexity infections were observed in 27.04% (43/159) of isolates from Afghanistan, 16.43% (35/213) from Pakistan, and 28.57% (10/35) from Bangladesh. Low prevalence of high-complexity infections was observed in Bhutan (3.70%; 1/27) and Nepal (5.26%; 1/19), suggesting lower superinfection or co-infection. Country-wide IBD analyses revealed 3 genetic clusters partitioning Bangladesh and Bhutan (partial) from the remaining countries. There were 2 subpopulations in Bhutan, which separated local and cross-border imported cases. Conclusions: Our results highlight the use of regional high-resolution genetic data to enhance monitoring of transmission intensity and cross-border importations.

Background: Globally common, lower respiratory tract infections (LRTIs) are especially difficult to manage in developing countries, where identifying the specific cause and determining the correct antibiotic treatment are major challenges. Methods: A cross-sectional study was conducted on patients with lower respiratory tract infections (LRTIs). A total of 1912 sputum samples were investigated for bacterial growth using standard microbiological methods. Isolates were identified through cultural, microscopic, and biochemical analyses, and subsequently subjected to antibiotic susceptibility testing. Results: Overall bacterial prevalence in sputum was found to be 11.7%. K. pnuemoniae was the predominant isolate recovered from 4.6% specimens. Altogether, isolates from 11 different genera were recovered in the study. Bacterial prevalence was more among male (13.8%) and people from age group 76-90 (16.7%). Similarly, bacterial LRTIs were found more prevalent during spring (14.4%) and summer (12.7%) seasons. All these associations were found statistically significant (p-value<0.01). AST pattern revealed most of the first and second-line drugs were ineffective against isolated organisms. For GNB, amikacin among first and second-line was found to be the most effective drug, whereas for S. aureus, ceftazidime and cefepime (100%) were found to be effective drug.Conclusion: Detection of bacterial agents from sputum and understanding the resistance pattern can be a basis for successful antimicrobial therapy and mapping a way-forward to mitigate the issue of MDR in Nepal.

Objective: The current study aims to explore the bacteriology of sputum of tuberculosis (TB) suspected patients. A cross-sectional study was carried out in the sputum samples of 150 TB suspected patients visiting District Public Health Office, Bharatpur, Nepal. The samples were subjected to cultural, microscopic and biochemical analyses for the identification of the isolates. In addition, antibiotic susceptibility tests were carried out with a special focus on ESBL and MBL production following Clinical and Laboratory Standard Institute guidelines.Results: Bacterial growth was recovered in 47% (71/150) of the TB suspected patients of which 12.66% (19/150) had pulmonary TB infection.Streptococcusspp. (9%) andPseudomonas aeruginosa(9%) were the most frequently isolated bacteria. Enterobacteriaceae accounted for 35% of the total isolates. Occurrence of bacterial pathogens was more in males (69%) than in females (31%).The incidence of bacterial pathogen was seen associated with gender of the patients and with the TB infection (p < 0.05) but independent with age of the patients and HIV infection (p > 0.05). Tetracycline was effective againstStreptococcusspp. whereas gentamicin was effective againstBacillusspecies. Imipenem and co-trimoxazole were effective drugs for Gram-negative isolates. Among 83 isolates, 35 were multi-drug resistant, 9 were ESBL producers and 4 were MBL producers.

Background. Motorcycle helmets can serve as a potential vehicle for the transmission of pathogenic bacteria and fungi with serious health implications. The main aim of this study was to explore the microbial diversity associated with the motorcycle helmets and determine the antibiotic susceptibility profile of the bacterial isolates. Methods. A descriptive cross-sectional study was carried out among the teaching staffs of Birendra Multiple Campus, Bharatpur, Nepal. A total of 130 motorcycle helmets worn by the teaching staffs of the Birendra Multiple Campus, Bharatpur, were included in the study for microbiological investigations. Results. Of the total 130 motorcycle helmets analyzed, 392 bacteria and 346 fungi belonging to seven different genera were recovered. Staphylococcus aureus 89 (22.7) was the predominant bacteria followed by S. epidermidis 77 (19.6) and E. coli 54 (13.8), whereas Aspergillus niger 67 (19.4) was the predominant fungi followed by A. fumigatus 49 (14.2). Antibiotic susceptibility test was performed by the disc diffusion method for all the bacterial isolates. Tetracycline, gentamycin, and cotrimoxazole were the most effective antibiotics for Gram-positive isolates, whereas Gram-negative isolates were sensitive towards imipenem and ciprofloxacin. Of the total bacterial isolates, 153 (39.0) were multidrug-resistant (MDR), 10.4 were extended-spectrum beta-lactamase (ESBL) producers, and 4.3 were metallo-beta-lactamase (MBL) producers and, out of 89 isolates of Staphylococcus aureus, 30 (33.7) were detected as methicillin-resistant Staphylococcus aureus (MRSA). Conclusion. The findings suggest that motorcycle riders should follow good hygiene practices and regularly clean their helmets with suitable sterilants to avoid the risk of microbial contamination and reduce the associated risks.