Prevalence of carbapenemase-producing Klebsiella pneumoniae at a tertiary care hospital in Kathmandu, Nepal
Abstract Aim Although carbapenem is the last-resort drug for treating drug-resistant Gram-negative bacterial infections, prevalence of carbapenem-resistant bacteria has substantially increased worldwide owing to irrational use of antibiotics particularly in developing countries like Nepal. Therefore...
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ftdoajarticles:oai:doaj.org/article:7c41a32a3aca47969402b8ee15920a86 2023-05-15T15:16:16+02:00 Prevalence of carbapenemase-producing Klebsiella pneumoniae at a tertiary care hospital in Kathmandu, Nepal Susil Pyakurel Mehraj Ansari Smriti Kattel Ganesh Rai Prasha Shrestha Kul Raj Rai Anil Kumar Sah Shiba Kumar Rai 2021-09-01T00:00:00Z https://doi.org/10.1186/s41182-021-00368-2 https://doaj.org/article/7c41a32a3aca47969402b8ee15920a86 EN eng BMC https://doi.org/10.1186/s41182-021-00368-2 https://doaj.org/toc/1349-4147 doi:10.1186/s41182-021-00368-2 1349-4147 https://doaj.org/article/7c41a32a3aca47969402b8ee15920a86 Tropical Medicine and Health, Vol 49, Iss 1, Pp 1-8 (2021) Carbapenemase MDR Colistin MHT Nepal Arctic medicine. Tropical medicine RC955-962 article 2021 ftdoajarticles https://doi.org/10.1186/s41182-021-00368-2 2022-12-31T13:50:25Z Abstract Aim Although carbapenem is the last-resort drug for treating drug-resistant Gram-negative bacterial infections, prevalence of carbapenem-resistant bacteria has substantially increased worldwide owing to irrational use of antibiotics particularly in developing countries like Nepal. Therefore, this study was aimed to determine the prevalence of carbapenemase-producing K. pneumoniae and to detect the carbapenemase genes (blaNDM-2 and blaOXA-48) in at a tertiary care hospital in Nepal. Materials and methods A hospital-based cross-sectional study was carried out from June 2018 to January 2019 at the Microbiology Laboratory of Annapurna Neurological Institute and Allied Sciences, Kathmandu, Nepal. Different clinical samples were collected and cultured in appropriate growth media. Biochemical tests were performed for the identification of K. pneumoniae. Antibiotic susceptibility testing (AST) was performed by the Kirby–Bauer disc diffusion method. The modified Hodge test (MHT) was performed to detect carbapenemase producers. The plasmid was extracted by the modified alkaline hydrolysis method. Carbapenemase-producing K. pneumoniae were further confirmed by detecting blaNDM-2 and blaOXA-48 genes by PCR using specific forward and reverse primers followed by gel electrophoresis. Results Out of the total 720 samples, 38.9% (280/720) were culture positive. K. pneumoniae was the most predominant isolate 31.4% (88/280). Of 88 K. pneumoniae isolates, 56.8% (50/88) were multi-drug resistant (MDR), and 51.1% (45/88) were MHT positive. Colistin showed the highest sensitivity (100%; 88/88), followed by tigecycline (86.4%; 76/88). blaNDM-2 and blaOXA-48 genes were detected in 24.4% (11/45) and 15.5% (7/45) of carbapenemase-producing K. pneumoniae isolates, respectively. Conclusion The rate of MDR and carbapenemase production was high in the K. pneumoniae isolates. Colistin and tigecycline could be the drug of choice for the empirical treatments of MDR and carbapenemase-producing K. pneumoniae. Our study provides a better ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Tropical Medicine and Health 49 1 |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
language |
English |
topic |
Carbapenemase MDR Colistin MHT Nepal Arctic medicine. Tropical medicine RC955-962 |
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Carbapenemase MDR Colistin MHT Nepal Arctic medicine. Tropical medicine RC955-962 Susil Pyakurel Mehraj Ansari Smriti Kattel Ganesh Rai Prasha Shrestha Kul Raj Rai Anil Kumar Sah Shiba Kumar Rai Prevalence of carbapenemase-producing Klebsiella pneumoniae at a tertiary care hospital in Kathmandu, Nepal |
topic_facet |
Carbapenemase MDR Colistin MHT Nepal Arctic medicine. Tropical medicine RC955-962 |
description |
Abstract Aim Although carbapenem is the last-resort drug for treating drug-resistant Gram-negative bacterial infections, prevalence of carbapenem-resistant bacteria has substantially increased worldwide owing to irrational use of antibiotics particularly in developing countries like Nepal. Therefore, this study was aimed to determine the prevalence of carbapenemase-producing K. pneumoniae and to detect the carbapenemase genes (blaNDM-2 and blaOXA-48) in at a tertiary care hospital in Nepal. Materials and methods A hospital-based cross-sectional study was carried out from June 2018 to January 2019 at the Microbiology Laboratory of Annapurna Neurological Institute and Allied Sciences, Kathmandu, Nepal. Different clinical samples were collected and cultured in appropriate growth media. Biochemical tests were performed for the identification of K. pneumoniae. Antibiotic susceptibility testing (AST) was performed by the Kirby–Bauer disc diffusion method. The modified Hodge test (MHT) was performed to detect carbapenemase producers. The plasmid was extracted by the modified alkaline hydrolysis method. Carbapenemase-producing K. pneumoniae were further confirmed by detecting blaNDM-2 and blaOXA-48 genes by PCR using specific forward and reverse primers followed by gel electrophoresis. Results Out of the total 720 samples, 38.9% (280/720) were culture positive. K. pneumoniae was the most predominant isolate 31.4% (88/280). Of 88 K. pneumoniae isolates, 56.8% (50/88) were multi-drug resistant (MDR), and 51.1% (45/88) were MHT positive. Colistin showed the highest sensitivity (100%; 88/88), followed by tigecycline (86.4%; 76/88). blaNDM-2 and blaOXA-48 genes were detected in 24.4% (11/45) and 15.5% (7/45) of carbapenemase-producing K. pneumoniae isolates, respectively. Conclusion The rate of MDR and carbapenemase production was high in the K. pneumoniae isolates. Colistin and tigecycline could be the drug of choice for the empirical treatments of MDR and carbapenemase-producing K. pneumoniae. Our study provides a better ... |
format |
Article in Journal/Newspaper |
author |
Susil Pyakurel Mehraj Ansari Smriti Kattel Ganesh Rai Prasha Shrestha Kul Raj Rai Anil Kumar Sah Shiba Kumar Rai |
author_facet |
Susil Pyakurel Mehraj Ansari Smriti Kattel Ganesh Rai Prasha Shrestha Kul Raj Rai Anil Kumar Sah Shiba Kumar Rai |
author_sort |
Susil Pyakurel |
title |
Prevalence of carbapenemase-producing Klebsiella pneumoniae at a tertiary care hospital in Kathmandu, Nepal |
title_short |
Prevalence of carbapenemase-producing Klebsiella pneumoniae at a tertiary care hospital in Kathmandu, Nepal |
title_full |
Prevalence of carbapenemase-producing Klebsiella pneumoniae at a tertiary care hospital in Kathmandu, Nepal |
title_fullStr |
Prevalence of carbapenemase-producing Klebsiella pneumoniae at a tertiary care hospital in Kathmandu, Nepal |
title_full_unstemmed |
Prevalence of carbapenemase-producing Klebsiella pneumoniae at a tertiary care hospital in Kathmandu, Nepal |
title_sort |
prevalence of carbapenemase-producing klebsiella pneumoniae at a tertiary care hospital in kathmandu, nepal |
publisher |
BMC |
publishDate |
2021 |
url |
https://doi.org/10.1186/s41182-021-00368-2 https://doaj.org/article/7c41a32a3aca47969402b8ee15920a86 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Tropical Medicine and Health, Vol 49, Iss 1, Pp 1-8 (2021) |
op_relation |
https://doi.org/10.1186/s41182-021-00368-2 https://doaj.org/toc/1349-4147 doi:10.1186/s41182-021-00368-2 1349-4147 https://doaj.org/article/7c41a32a3aca47969402b8ee15920a86 |
op_doi |
https://doi.org/10.1186/s41182-021-00368-2 |
container_title |
Tropical Medicine and Health |
container_volume |
49 |
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1 |
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1766346563106373632 |