Books by Prof. Dr. Chandra Prakash Bhatt
Journal of Nepal Medical Association, 2021
Introduction: Methicillin-Resistant Staphylococcus aureus exhibit multiple drug resistance phenot... more Introduction: Methicillin-Resistant Staphylococcus aureus exhibit multiple drug resistance phenotypes. Colonizers harboring Methicillin-Resistant Staphylococcus aureus are often associated with its outbreaks in both hospital and community settings. This study was done to determine the prevalence of nasal carriage rate of Methicillin-Resistant Staphylococcus aureus among basic science MBBS and BDS students of Kathmandu Medical College.
Methods: A descriptive cross-sectional study was done in Kathmandu Medical College from March 5 to June 5 2020. Ethical clearance was obtained from the Institutional Review Committee with reference no. 040320201. A convenient sampling method was used, and the sample size was calculated with a prevalence of 50%. Two hundred students studying MBBS and BDS were enrolled. The nasal swab was collected and processed using standard microbiological methods. The data obtained were computed and analyzed using Statistical Package for Social Sciences 16.0 Version.
Results: Among 200 participants, 9 (4.5%) were found to be nasal carriers of Methicillin-Resistant Staphylococcus aureus.
Conclusions: Colonization of anterior nares by Methicillin-Resistant Staphylococcus aureus in apparently healthy individuals is a cause of concern. Education regarding Methicillin-Resistant Staphylococcus aureus, its carrier and significance, and its screening must be included early on in MBBS and BDS.
Nepal Medical College Journal, 2021
Researchers in 2004 found that tear flim can be one of the modes of transmission of SARS-CoV. Con... more Researchers in 2004 found that tear flim can be one of the modes of transmission of SARS-CoV. Considering the fact that SARS-CoV-2 is similar to SARS-CoV, it is speculated that there may be a risk of transmission through tear flim in patients with COVID-19. Therefore, this study was conducted to understand whether COVID-19 viral genome is present in the tear film or not. It was a cross-sectional quantitative study done in Kathmandu Medical College Teaching Hospital, Duwakot. Tear sample collection was done using schirmer’s strip and conjunctival swab of confirmed COVID-19 positive admitted cases and then the sample was sent for viral genome analysis. Especially designed proforma was used for recording the patient demographics, history, clinical examination findings and investigations results. Data were analyzed using the Statistical Package for the Social Sciences (version 21) and expressed in frequency, percentage and mean. Out of 30 enrolled patients, 23.3% (n=7) showed positive results in tear RT-PCR test for SARS-CoV-2. Among them, 85.7% (n=6) had positive tear sample RT-PCR on the very first day of sample collection with their CT value in tear sample ranging from 30-35. Patients who were positive were mostly in the age group of 21-30 years (71.4%) and were local vendors by occupation (71.4%). However, none of the patients had any ocular symptoms. Tear sample analysis with RT-PCR showed 23.3% positivity for SARS-CoV-2. Early collection and analysis of tear sample can yield maximum positive results therefore tear film could be one of the modes of transmission of SARS-CoV-2 virus.
ournal of Kathmandu Medical College 7(2):64 , 2018
Background: The presence of Staphylococcus aureus in anterior nares of health care workers may se... more Background: The presence of Staphylococcus aureus in anterior nares of health care workers may serve as a major source of infection in hospital environment and act as a reservoir for the spread of Methicillin Resistant S. aureus between patients.
Objective: The present study was conducted to determine the frequency of nasal carriage of S. aureus among the health care workers of Kathmandu Medical College Teaching Hospital and to assess the antibioticsusceptibility patterns of the Methicillin Resistant S. aureus isolates.
Methodology: A total of 200 health care workers involved in the management of patients from the intensive care unit, Operation Theatre, postoperative wards, different wards and emergency department were screened for S. aureus by collecting their nasal swabs.
Results: Out of 200 health care workers, only 10(5%) were S. aureus nasal carriers. Out of 10 S. aureus strains isolated six (60%) were methicillin sensitive S. aureus whereas four (40%) were methicillin resistant S. aureus . The isolates were 100% sensitive to Linezolid, Vancomycin and Amikacin but showed highest resistant to Azithromycin (100%), followed by Cefixime (60%).
Conclusion: This study concluded that 5% of health care workers were S. aureus carriers and proportion of Methicillin Resistant S. aureus and Methicillin sensitive S. aureus was 60% and 40% respectively. Journal of Kathmandu Medical College Vol. 7, No. 2, Issue 24, Apr.-Jun., 2018, page: 64-67</p
International Journal of Biomedical Research ISSN: 0976-9633 (Online); 2455-0566 (Print) Journal DOI: 10.7439/ijbr CODEN: IJBRFA , 2015
Background: Bacterial infections have been recognized with infertility, bacteria are capable of a... more Background: Bacterial infections have been recognized with infertility, bacteria are capable of agglutinating and immobilizing spermatozoa.
The aim of present study was to determine bacterial pathogens in semen culture from infertile men and their antibiotic susceptibility pattern in vitro.
Method: Semen samples were collected for routine culture and antibiotic susceptibility test and were processed according to the standard microbiology techniques.
Results: A total of 347 semen specimens were cultured, of which 62 (17.8%) showed significant bacterial growth. Eight different species of bacterial organisms were isolated out of them 37% isolates were gram positive and 62.9% isolates were gram negative. The commonest isolates were Escherichia coli (41.9%) followed by Staphylococcus aureus (17.7%), Streptococcus faecalis (11.2%), Klebsiella pneumoniae (9.6%), Staphylococcus saprophyticus (8%), and Pseudomonas aeruginosa (4.8%). The maximum numbers of culture positive cases (46.7%) were found in patients 31-40 year age group. Both gram positive and gram negative organisms were sensitive to nitrofurantoin (91.5%) and (71.7%) followed by ampicillin- sulbactam (73.9%) and (58.9%), levofloxacin (56.5%) and (71.7%) and gentamycin (56.5%) and (53.8%) respectively. E. coli was found susceptible to nitrofurantoin (76.9%), followed by levofloxacin (69.2%), ampicillin sulbactam (57.6%) and gentamycin (61.5%) and co-trimoxazole (50%). Staphylococcus aureus was found 81.83% sensitive to nitrofurantoin followed by lavofloxacin (63.6%) and gentamycin (54.5%).
Conclusion: For empirical treatment nitrofurantion seems to be drug of choice followed by lavofloxacin and ampicillin sulbactam. The regular screening of bacterial pathogen in infertile man seems necessary because it affects infertility in several ways.
Keywords: Antibiotic, Escherichia coli, Infertility, Semen, Staphylococcus aureus
J Nepal Health Res Counc 2018 Oct-Dec;16(41): 434-7, 2018
Background:Dermatophytosis are the most common types of cutaneous fungal infection seen... more Background:Dermatophytosis are the most common types of cutaneous fungal infection seen in human and animals affecting skin, hair and nails caused by dermatophytes. The diagnosis of dermatophytes is based on the clinical observation and laboratory diagnosis by direct microscopic examination and fungal cultures. The present study is undertaken to isolate different type of dermatophytes causing fungal infection.
Methods:A prospective cross-sectional study design was used in a total of 90 clinically suspected cases of dermatophytic infection attending the out patient department of Kathmandu Medical College and Teaching hospital (KMCTH). Skin scraping, hair and nail samples were collected from the patients and were processed by direct microscopy and culture using standard protocol. Dermatophytes were identified based on the microscopic arrangement of microconidia and macroconidia.
Results:Dermatophytosis was more common in the age group of 21-40 years and was more predominant among male with male to female ratio of 1.7: 1. Among the total clinically suspected cases of dermatophytosis, 53 were positive in direct microscopy and only a total of 20 were positive by culture. Most common clinical type observed in our study was Tinea corporis(25%) followed by Tinea cruris. Trichophyton rubrum(50%) was the commonest aetiological agent in majority of clinical types followed by Trychophyton mentagrophytes(35%).
Conclusions: The study highlighted T. corporis followed by T. cruris and T. unguim as the most common clinical pattern of dermatophytosis with a male predominance and 21-40 years being the most affected age group. T. rubramwas the most common aetiological agent causing dermatophytosis.Keywords: Dermatophytes; dermatophytosis; epidermophyton; tinea; trychophyton.
J Nepal Med Assoc 2019;57(220):424-428, 2019
Introduction: Acinetobacter species are short, stout, gram-negative coccobacilli, generally consi... more Introduction: Acinetobacter species are short, stout, gram-negative coccobacilli, generally considered to be a relatively low-grade pathogen. However, its resistance towards multiple classes of antibiotics through an array of resistance mechanisms including its ability to form biofilm has led to its emergence as an important pathogen in hospital settings. This study was done to determine the prevalence of biofilm former and Extended-spectrum Beta-Lactamase producer among Acinetobacter species.Methods: A descriptive cross-sectional study was done in the clinical microbiology laboratory, Kathmandu Medical College from January to June 2019. Convenient sampling method was used. Ethical approval was taken from the Institutional Review Committee, Ref no. 2812201805. Preliminary identification followed by characterization of Acinetobacter spp. was done. Antibiotic susceptibility test was done using the Kirby-Bauer method following Clinical and Laboratory Standards Institute guidelines. Extended-spectrum Beta-Lactamase was detected by combined disc method and Biofilm detection was done using congo red agar method. Statistical Package for Social Sciences 16.0 version statistical software package was used for statistical analysis. Point estimate at 95% Confidence Interval was calculated along with frequencyand proportion for binarydata.Results: Among 108 Acinetobacter species, 86 (79.7%) Acinetobacter calcoaceticus-A. baumannii (Acb) complex was seen. Seventy-eight (72%) of the isolates were multidrug-resistant, 34 (31%) of the isolates were Extended-spectrum Beta-Lactamase producer and only 10 (9.3%) of the isolates were biofilm producers. Conclusions: Multidrug-resistant Acinetobacter spp. with the ability to produce Extended-spectrum Beta-Lactamase is prevalent in our hospital settings. Strict compliance with infection control practices is necessary to curb its spread. _______________________________________________________________________________
J Clin Diagn Res. 2013 Apr; 7(4): 638–641., 2013
Background: Bloodstream infections are associated with a significant patient morbidity and mortal... more Background: Bloodstream infections are associated with a significant patient morbidity and mortality. The detection of microorganisms in the patients’ blood has a great diagnostic and prognostic significance. The early positive results provide valuable diagnostic information, based on which the appropriate antimicrobial therapy can be initiated.
Objective: To know the aetiology of the bloodstream infections in the Kathmandu Medical College, Nepal and the antibiotic sensitivity patterns of the causative organisms.
Materials and Methods: The blood specimens which were received from May 2010 to October 2010 in Kathmandu Medical College and Teaching Hospital, Kathmandu, Nepal, were processed and all the positive isolates were included in the study. The isolates were identified by the standard laboratory procedures. The antibiotic susceptibility patterns were determined by the modified Kirby Bauer antibiotic sensitivity method.
Result: Of the 1089 blood cultures which were received with the suspected cases of blood stream infections, 138 (12.6 %) were bacteriologically positive. Salmonella serotypes were isolated in 42.7% cases of blood stream infections, followed by Klebsiella pneumoniae in 19.5%, Staphylococcus aureus in 15.9% and others in the rest of the cases. All the gram-negative bacilli isolates showed lower degrees of resistance to amikacin and ofloxacin. All the gram positive isolates were sensitive to amikacin, oxacillin and vancomycin.
Conclusion: This study stresses on the need for a continued screening and surveillance in the routine blood culture technique for starting with the empiric therapy for blood borne infections.
Keywords: Bloodstream infection, Blood culture, Antibiotic susceptibility, Salmonella spp
J Nepal Med Assoc 2019;57(220):398-402, 2019
Introduction: Staphylococcus aureus is one of the commonest cause of nosocomial infections.
Resis... more Introduction: Staphylococcus aureus is one of the commonest cause of nosocomial infections.
Resistant Staphylococcus aureus strain has become a matter of concern. This study was done to find
out the prevalence of Staphylococcus aureus from different clinical samples.
Methods: This descriptive cross-sectional study was carried out in the Clinical Microbiology
laboratory from January 2019 to June 2019. Ethical approval was received from the Institutional
Review Committee (Ref: 28122018010). Six hundred sixty-six sample size was calculated. Convenient
sampling was done. Staphylococcus aureus was identified on the basis of its microscopy and
morphological characteristics followed by catalase and coagulase test. Antibiotic sensitivity test of
isolated pathogens was done using Muller Hinton Agar by Kirby-Bauer method. Statistical analysis
was done by Excel 2018, point estimate at 95% confidence interval was calculated along with
frequency and proportion for binary data.
Results: Out of the 666 bacteria isolated from clinical specimens, 133 (19.96%) were Staphylococcus
aureus at 95% confidence interval (12.91-13.60%). Seventy nine (78.95%) of which is isolated from
pus and wound infections. Out of 133 Staphylococcus aureus, 94 (70.64%) were Methicillin-Resistant
Staphylococcus aureus.
Conclusions: This study provides valuable information regarding the high prevalence of
Staphylococcus aureus from pus and wound infections. The alarming number of Methicillin-Resistant
Staphylococcus aureus is worrisome finding. Antibiotics like Vancomycin and Linezolid which has
not developed resistance should be cautiously used only in Methicillin-Resistant Staphylococcus
aureus cases.
________________________________________________________________________________________
Keywords: antibiotic resistance; MRSA; Staphylococcus aureus.
This textbook provides a system based approach to Medical Microbiology; comprising 100 chapters i... more This textbook provides a system based approach to Medical Microbiology; comprising 100 chapters included bacteriology, virology, mycology, parasitology and immunology. The book provides all essential information regarding the general characters of microorganisms i.e., morphology, antigenic structure, pathogenesis, clinical manifestations, method of specimen collection, microscopic examination, culture, identification of microorganism, treatment, prevention and control. Regarding examination point of view each chapter have been provided with questions such as long answer questions, short answer questions and multiple choice questions. It will help students to overcome their nervousness and stress in examination period and built self confidence. This book has been written in simple language, easily understandable, need based; well labeled diagram and tables have been furnished at appropriate places. This textbook would be useful for the students of medical, dental, nursing and paramedical sciences of graduate and postgraduate levels. It is also hoped that it will serve as a resource for teachers of microbiology and medical professionals.
The book provides information regarding the general characters of bacterial organisms, antigenic ... more The book provides information regarding the general characters of bacterial organisms, antigenic structure, diseases produce, clinical manifestations, methods of specimen collection, microscopic examination, isolation and identification of bacterial organisms and their treatment. This book is divided into six different sections such as section "A" general microbiology, section "B" systemic bacteriology, section "C" microscopic examination, section "D" culture, section "E" biochemical test and section "F" serological diagnosis of microbial disease. This textbook would be useful for the students of medical and paramedical sciences graduate and post-graduate levels.
Papers by Prof. Dr. Chandra Prakash Bhatt
Large amounts of antibiotics used for human therapy has resulted in the selection of pathogenic b... more Large amounts of antibiotics used for human therapy has resulted in the selection of pathogenic bacteria resistant to multiple antimicrobial drugs. This has created problems in the treatment of patients. So, this study was carried out to determine multidrug resistant (MDR) bacterial pathogens and their antibiogram in patients with clinically suspected pneumonia attending a tertiary care centre in central Nepal. Specimens representing lower respiratory tract were processed using standard protocol. Antibiotic susceptibility test was performed on bacterial pathogens by Kirby-Bauer disk diffusion method following Clinical and Laboratory Standards Institute guidelines. Fifty-four percent of the total bacterial isolates were MDR. Multidrug resistance was found in Klebsiella pneumoniae (23.4%), Pseudomonads (20.5%), Acinetobacter calcoaceticus baumannii complex (20.6%), Escherichia coli (11.6%), Staphylococcus aureus (9.1%) and others. Non-fermentative bacteria were more multidrug resistan...
SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS, 2017
Tuberculosis (TB) is a major public health problem in Nepal. About 45 percent of the total popula... more Tuberculosis (TB) is a major public health problem in Nepal. About 45 percent of the total population is infected with TB, of which 60 percent are adult. Every year, 45,000 people develop active TB, of
Abstract Resistance of Mycobacterium tuberculosis to antituberculous drugs has emerged as a major... more Abstract Resistance of Mycobacterium tuberculosis to antituberculous drugs has emerged as a major public health threat. The short course therapy with rifampicin, isoniazid and pyrazinamide is the most effective regimen against tuberculosis. The efficacy of this regimen is hampered in regions where there is a high initial resistance to rifampicin. The objective of this study was to determine types. frequency and location of mutation in rifampicin resistant Mycobacterium tuberculosis strains isolated from patients of DOTS peogramme in Nepal In the present study rifampicin resistant Mycobacterium tuberculosis isolates obtained from patients of tuberculosis were analyzed for mutation of rifampicin rpoB gene. In these samples the coding gerion of rpoB gene encoding DNA dependent RNA polymerase were amplified by standard polymerase chain reaction (PCR) and DNA sequencing by ABI prism 3100 Avant genetic analyzer with big dye terminator kit. Two different mutations were identified in rifamp...
Journal of Nepal Health Research Council, 2019
Background: Dermatophytosis are the most common types of cutaneous fungal infection seen in human... more Background: Dermatophytosis are the most common types of cutaneous fungal infection seen in human and animals affecting skin, hair and nails caused by dermatophytes. The diagnosis of dermatophytes is based on the clinical observation and laboratory diagnosis by direct microscopic examination and fungal cultures. The present study is undertaken to isolate different type of dermatophytes causing fungal infection.Methods: A prospective cross-sectional study design was used in a total of 90 clinically suspected cases of dermatophytic infection attending the out patient department of Kathmandu Medical College and Teaching hospital (KMCTH). Skin scraping, hair and nail samples were collected from the patients and were processed by direct microscopy and culture using standard protocol. Dermatophytes were identified based on the microscopic arrangement of microconidia and macroconidia.Results: Dermatophytosis was more common in the age group of 21-40 years and was more predominant among mal...
Journal of Health and Allied Sciences, 2019
Voluntary counseling and testing (VCT) of HIV is important intervention for the prevention of HIV... more Voluntary counseling and testing (VCT) of HIV is important intervention for the prevention of HIV infection. Aim of this study was to find out HIV status and high risk behavior of men having sex with men. This descriptive cross sectional study was conducted among men having sex with men (MSM) by administering structured questionnaires. The number of risk factors in a single individual ranged from one to seven out of eight. The mean risk factor was 3.38, with standard deviation 1.3. More than half (55.33%) of them perceived at low risk, 33% perceived themselves at high risk. Regarding HIV status of respondents, 8% were found to be positive. In the past 30 days the respondents had large number of sex partners; majorities of them 90% and 87.3% had 0-20 regular and casual sex partners but 9.8% of MSM had 21-40 regular sex partners and 2.9% had 81-100 casual sex partners respectively. Among the MSM 46.6% were commercial sex worker, 35% were sex drives and 18.4% were intravenous drug user...
Journal of Kathmandu Medical College, 2018
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Books by Prof. Dr. Chandra Prakash Bhatt
Methods: A descriptive cross-sectional study was done in Kathmandu Medical College from March 5 to June 5 2020. Ethical clearance was obtained from the Institutional Review Committee with reference no. 040320201. A convenient sampling method was used, and the sample size was calculated with a prevalence of 50%. Two hundred students studying MBBS and BDS were enrolled. The nasal swab was collected and processed using standard microbiological methods. The data obtained were computed and analyzed using Statistical Package for Social Sciences 16.0 Version.
Results: Among 200 participants, 9 (4.5%) were found to be nasal carriers of Methicillin-Resistant Staphylococcus aureus.
Conclusions: Colonization of anterior nares by Methicillin-Resistant Staphylococcus aureus in apparently healthy individuals is a cause of concern. Education regarding Methicillin-Resistant Staphylococcus aureus, its carrier and significance, and its screening must be included early on in MBBS and BDS.
Objective: The present study was conducted to determine the frequency of nasal carriage of S. aureus among the health care workers of Kathmandu Medical College Teaching Hospital and to assess the antibioticsusceptibility patterns of the Methicillin Resistant S. aureus isolates.
Methodology: A total of 200 health care workers involved in the management of patients from the intensive care unit, Operation Theatre, postoperative wards, different wards and emergency department were screened for S. aureus by collecting their nasal swabs.
Results: Out of 200 health care workers, only 10(5%) were S. aureus nasal carriers. Out of 10 S. aureus strains isolated six (60%) were methicillin sensitive S. aureus whereas four (40%) were methicillin resistant S. aureus . The isolates were 100% sensitive to Linezolid, Vancomycin and Amikacin but showed highest resistant to Azithromycin (100%), followed by Cefixime (60%).
Conclusion: This study concluded that 5% of health care workers were S. aureus carriers and proportion of Methicillin Resistant S. aureus and Methicillin sensitive S. aureus was 60% and 40% respectively. Journal of Kathmandu Medical College Vol. 7, No. 2, Issue 24, Apr.-Jun., 2018, page: 64-67</p
The aim of present study was to determine bacterial pathogens in semen culture from infertile men and their antibiotic susceptibility pattern in vitro.
Method: Semen samples were collected for routine culture and antibiotic susceptibility test and were processed according to the standard microbiology techniques.
Results: A total of 347 semen specimens were cultured, of which 62 (17.8%) showed significant bacterial growth. Eight different species of bacterial organisms were isolated out of them 37% isolates were gram positive and 62.9% isolates were gram negative. The commonest isolates were Escherichia coli (41.9%) followed by Staphylococcus aureus (17.7%), Streptococcus faecalis (11.2%), Klebsiella pneumoniae (9.6%), Staphylococcus saprophyticus (8%), and Pseudomonas aeruginosa (4.8%). The maximum numbers of culture positive cases (46.7%) were found in patients 31-40 year age group. Both gram positive and gram negative organisms were sensitive to nitrofurantoin (91.5%) and (71.7%) followed by ampicillin- sulbactam (73.9%) and (58.9%), levofloxacin (56.5%) and (71.7%) and gentamycin (56.5%) and (53.8%) respectively. E. coli was found susceptible to nitrofurantoin (76.9%), followed by levofloxacin (69.2%), ampicillin sulbactam (57.6%) and gentamycin (61.5%) and co-trimoxazole (50%). Staphylococcus aureus was found 81.83% sensitive to nitrofurantoin followed by lavofloxacin (63.6%) and gentamycin (54.5%).
Conclusion: For empirical treatment nitrofurantion seems to be drug of choice followed by lavofloxacin and ampicillin sulbactam. The regular screening of bacterial pathogen in infertile man seems necessary because it affects infertility in several ways.
Keywords: Antibiotic, Escherichia coli, Infertility, Semen, Staphylococcus aureus
Methods:A prospective cross-sectional study design was used in a total of 90 clinically suspected cases of dermatophytic infection attending the out patient department of Kathmandu Medical College and Teaching hospital (KMCTH). Skin scraping, hair and nail samples were collected from the patients and were processed by direct microscopy and culture using standard protocol. Dermatophytes were identified based on the microscopic arrangement of microconidia and macroconidia.
Results:Dermatophytosis was more common in the age group of 21-40 years and was more predominant among male with male to female ratio of 1.7: 1. Among the total clinically suspected cases of dermatophytosis, 53 were positive in direct microscopy and only a total of 20 were positive by culture. Most common clinical type observed in our study was Tinea corporis(25%) followed by Tinea cruris. Trichophyton rubrum(50%) was the commonest aetiological agent in majority of clinical types followed by Trychophyton mentagrophytes(35%).
Conclusions: The study highlighted T. corporis followed by T. cruris and T. unguim as the most common clinical pattern of dermatophytosis with a male predominance and 21-40 years being the most affected age group. T. rubramwas the most common aetiological agent causing dermatophytosis.Keywords: Dermatophytes; dermatophytosis; epidermophyton; tinea; trychophyton.
Objective: To know the aetiology of the bloodstream infections in the Kathmandu Medical College, Nepal and the antibiotic sensitivity patterns of the causative organisms.
Materials and Methods: The blood specimens which were received from May 2010 to October 2010 in Kathmandu Medical College and Teaching Hospital, Kathmandu, Nepal, were processed and all the positive isolates were included in the study. The isolates were identified by the standard laboratory procedures. The antibiotic susceptibility patterns were determined by the modified Kirby Bauer antibiotic sensitivity method.
Result: Of the 1089 blood cultures which were received with the suspected cases of blood stream infections, 138 (12.6 %) were bacteriologically positive. Salmonella serotypes were isolated in 42.7% cases of blood stream infections, followed by Klebsiella pneumoniae in 19.5%, Staphylococcus aureus in 15.9% and others in the rest of the cases. All the gram-negative bacilli isolates showed lower degrees of resistance to amikacin and ofloxacin. All the gram positive isolates were sensitive to amikacin, oxacillin and vancomycin.
Conclusion: This study stresses on the need for a continued screening and surveillance in the routine blood culture technique for starting with the empiric therapy for blood borne infections.
Keywords: Bloodstream infection, Blood culture, Antibiotic susceptibility, Salmonella spp
Resistant Staphylococcus aureus strain has become a matter of concern. This study was done to find
out the prevalence of Staphylococcus aureus from different clinical samples.
Methods: This descriptive cross-sectional study was carried out in the Clinical Microbiology
laboratory from January 2019 to June 2019. Ethical approval was received from the Institutional
Review Committee (Ref: 28122018010). Six hundred sixty-six sample size was calculated. Convenient
sampling was done. Staphylococcus aureus was identified on the basis of its microscopy and
morphological characteristics followed by catalase and coagulase test. Antibiotic sensitivity test of
isolated pathogens was done using Muller Hinton Agar by Kirby-Bauer method. Statistical analysis
was done by Excel 2018, point estimate at 95% confidence interval was calculated along with
frequency and proportion for binary data.
Results: Out of the 666 bacteria isolated from clinical specimens, 133 (19.96%) were Staphylococcus
aureus at 95% confidence interval (12.91-13.60%). Seventy nine (78.95%) of which is isolated from
pus and wound infections. Out of 133 Staphylococcus aureus, 94 (70.64%) were Methicillin-Resistant
Staphylococcus aureus.
Conclusions: This study provides valuable information regarding the high prevalence of
Staphylococcus aureus from pus and wound infections. The alarming number of Methicillin-Resistant
Staphylococcus aureus is worrisome finding. Antibiotics like Vancomycin and Linezolid which has
not developed resistance should be cautiously used only in Methicillin-Resistant Staphylococcus
aureus cases.
________________________________________________________________________________________
Keywords: antibiotic resistance; MRSA; Staphylococcus aureus.
Papers by Prof. Dr. Chandra Prakash Bhatt
Methods: A descriptive cross-sectional study was done in Kathmandu Medical College from March 5 to June 5 2020. Ethical clearance was obtained from the Institutional Review Committee with reference no. 040320201. A convenient sampling method was used, and the sample size was calculated with a prevalence of 50%. Two hundred students studying MBBS and BDS were enrolled. The nasal swab was collected and processed using standard microbiological methods. The data obtained were computed and analyzed using Statistical Package for Social Sciences 16.0 Version.
Results: Among 200 participants, 9 (4.5%) were found to be nasal carriers of Methicillin-Resistant Staphylococcus aureus.
Conclusions: Colonization of anterior nares by Methicillin-Resistant Staphylococcus aureus in apparently healthy individuals is a cause of concern. Education regarding Methicillin-Resistant Staphylococcus aureus, its carrier and significance, and its screening must be included early on in MBBS and BDS.
Objective: The present study was conducted to determine the frequency of nasal carriage of S. aureus among the health care workers of Kathmandu Medical College Teaching Hospital and to assess the antibioticsusceptibility patterns of the Methicillin Resistant S. aureus isolates.
Methodology: A total of 200 health care workers involved in the management of patients from the intensive care unit, Operation Theatre, postoperative wards, different wards and emergency department were screened for S. aureus by collecting their nasal swabs.
Results: Out of 200 health care workers, only 10(5%) were S. aureus nasal carriers. Out of 10 S. aureus strains isolated six (60%) were methicillin sensitive S. aureus whereas four (40%) were methicillin resistant S. aureus . The isolates were 100% sensitive to Linezolid, Vancomycin and Amikacin but showed highest resistant to Azithromycin (100%), followed by Cefixime (60%).
Conclusion: This study concluded that 5% of health care workers were S. aureus carriers and proportion of Methicillin Resistant S. aureus and Methicillin sensitive S. aureus was 60% and 40% respectively. Journal of Kathmandu Medical College Vol. 7, No. 2, Issue 24, Apr.-Jun., 2018, page: 64-67</p
The aim of present study was to determine bacterial pathogens in semen culture from infertile men and their antibiotic susceptibility pattern in vitro.
Method: Semen samples were collected for routine culture and antibiotic susceptibility test and were processed according to the standard microbiology techniques.
Results: A total of 347 semen specimens were cultured, of which 62 (17.8%) showed significant bacterial growth. Eight different species of bacterial organisms were isolated out of them 37% isolates were gram positive and 62.9% isolates were gram negative. The commonest isolates were Escherichia coli (41.9%) followed by Staphylococcus aureus (17.7%), Streptococcus faecalis (11.2%), Klebsiella pneumoniae (9.6%), Staphylococcus saprophyticus (8%), and Pseudomonas aeruginosa (4.8%). The maximum numbers of culture positive cases (46.7%) were found in patients 31-40 year age group. Both gram positive and gram negative organisms were sensitive to nitrofurantoin (91.5%) and (71.7%) followed by ampicillin- sulbactam (73.9%) and (58.9%), levofloxacin (56.5%) and (71.7%) and gentamycin (56.5%) and (53.8%) respectively. E. coli was found susceptible to nitrofurantoin (76.9%), followed by levofloxacin (69.2%), ampicillin sulbactam (57.6%) and gentamycin (61.5%) and co-trimoxazole (50%). Staphylococcus aureus was found 81.83% sensitive to nitrofurantoin followed by lavofloxacin (63.6%) and gentamycin (54.5%).
Conclusion: For empirical treatment nitrofurantion seems to be drug of choice followed by lavofloxacin and ampicillin sulbactam. The regular screening of bacterial pathogen in infertile man seems necessary because it affects infertility in several ways.
Keywords: Antibiotic, Escherichia coli, Infertility, Semen, Staphylococcus aureus
Methods:A prospective cross-sectional study design was used in a total of 90 clinically suspected cases of dermatophytic infection attending the out patient department of Kathmandu Medical College and Teaching hospital (KMCTH). Skin scraping, hair and nail samples were collected from the patients and were processed by direct microscopy and culture using standard protocol. Dermatophytes were identified based on the microscopic arrangement of microconidia and macroconidia.
Results:Dermatophytosis was more common in the age group of 21-40 years and was more predominant among male with male to female ratio of 1.7: 1. Among the total clinically suspected cases of dermatophytosis, 53 were positive in direct microscopy and only a total of 20 were positive by culture. Most common clinical type observed in our study was Tinea corporis(25%) followed by Tinea cruris. Trichophyton rubrum(50%) was the commonest aetiological agent in majority of clinical types followed by Trychophyton mentagrophytes(35%).
Conclusions: The study highlighted T. corporis followed by T. cruris and T. unguim as the most common clinical pattern of dermatophytosis with a male predominance and 21-40 years being the most affected age group. T. rubramwas the most common aetiological agent causing dermatophytosis.Keywords: Dermatophytes; dermatophytosis; epidermophyton; tinea; trychophyton.
Objective: To know the aetiology of the bloodstream infections in the Kathmandu Medical College, Nepal and the antibiotic sensitivity patterns of the causative organisms.
Materials and Methods: The blood specimens which were received from May 2010 to October 2010 in Kathmandu Medical College and Teaching Hospital, Kathmandu, Nepal, were processed and all the positive isolates were included in the study. The isolates were identified by the standard laboratory procedures. The antibiotic susceptibility patterns were determined by the modified Kirby Bauer antibiotic sensitivity method.
Result: Of the 1089 blood cultures which were received with the suspected cases of blood stream infections, 138 (12.6 %) were bacteriologically positive. Salmonella serotypes were isolated in 42.7% cases of blood stream infections, followed by Klebsiella pneumoniae in 19.5%, Staphylococcus aureus in 15.9% and others in the rest of the cases. All the gram-negative bacilli isolates showed lower degrees of resistance to amikacin and ofloxacin. All the gram positive isolates were sensitive to amikacin, oxacillin and vancomycin.
Conclusion: This study stresses on the need for a continued screening and surveillance in the routine blood culture technique for starting with the empiric therapy for blood borne infections.
Keywords: Bloodstream infection, Blood culture, Antibiotic susceptibility, Salmonella spp
Resistant Staphylococcus aureus strain has become a matter of concern. This study was done to find
out the prevalence of Staphylococcus aureus from different clinical samples.
Methods: This descriptive cross-sectional study was carried out in the Clinical Microbiology
laboratory from January 2019 to June 2019. Ethical approval was received from the Institutional
Review Committee (Ref: 28122018010). Six hundred sixty-six sample size was calculated. Convenient
sampling was done. Staphylococcus aureus was identified on the basis of its microscopy and
morphological characteristics followed by catalase and coagulase test. Antibiotic sensitivity test of
isolated pathogens was done using Muller Hinton Agar by Kirby-Bauer method. Statistical analysis
was done by Excel 2018, point estimate at 95% confidence interval was calculated along with
frequency and proportion for binary data.
Results: Out of the 666 bacteria isolated from clinical specimens, 133 (19.96%) were Staphylococcus
aureus at 95% confidence interval (12.91-13.60%). Seventy nine (78.95%) of which is isolated from
pus and wound infections. Out of 133 Staphylococcus aureus, 94 (70.64%) were Methicillin-Resistant
Staphylococcus aureus.
Conclusions: This study provides valuable information regarding the high prevalence of
Staphylococcus aureus from pus and wound infections. The alarming number of Methicillin-Resistant
Staphylococcus aureus is worrisome finding. Antibiotics like Vancomycin and Linezolid which has
not developed resistance should be cautiously used only in Methicillin-Resistant Staphylococcus
aureus cases.
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Keywords: antibiotic resistance; MRSA; Staphylococcus aureus.