title: Emerging Perils of Extended Spectrumβ-Lactamase Producing Enterobacteriaceae Clinical Isolates in a Teaching Hospital of Nepal.
abstract: Introduction. Infections due to extended spectrumβ-lactamase producing Enterobacteriaceae are on the rise. They pose serious public health problems due to their resistance to large number of antibiotics. However, little is known about the genotypes of ESBL from Nepal. Therefore, the study presents results of phenotypic and molecular characterization of ESBL producingEscherichia coliandKlebsiellaspp. isolated from various clinical specimens in a tertiary care teaching hospital of Nepal.Methods. A total of 172 Enterobacteriaceae clinical isolates recovered from various clinical specimens were analyzed for their antibiotic susceptibility test. Detection of ESBLs was carried out using combination disk test and multiplex PCR for their genotypes (CTX-M, SHV, and TEM).Results. Out of 172 clinical isolates, 70 (40.6%) of them were found ESBL producers. The major source of ESBL producers was urinary tract samples and the highest ESBL production was observed inEscherichia coli(46.5%). Among ESBL genotypes, CTX-M (91.4%) was most predominant, followed by TEM (65.7%) and SHV (11.4%) in both of the isolates.Conclusions. High level of drug resistance and ESBL production was observed among the clinical isolates. There is a need for longitudinal and nationwide surveillance for drug resistance in clinical isolates and antimicrobial stewardship is necessary to guide the appropriate and judicious antibiotic use.
authors.affiliation: Department of Laboratory Medicine, Manmohan Memorial Medical College and Teaching Hospital, Kathmandu, Nepal; Department of Clinical Microbiology, Manmohan Memorial Medical College and Teaching Hospital, Kathmandu, Nepal.
authors.forename: Narayan Prasad
authors.identifier: 0000-0002-3228-9908
authors.initials: NP
authors.lastname: Parajuli
authors.affiliation: Department of Laboratory Medicine, Manmohan Memorial Medical College and Teaching Hospital, Kathmandu, Nepal.
authors.forename: Pooja
authors.initials: P
authors.lastname: Maharjan
authors.affiliation: Department of Laboratory Medicine, Manmohan Memorial Medical College and Teaching Hospital, Kathmandu, Nepal.
authors.forename: Govardhan
authors.initials: G
authors.lastname: Joshi
authors.affiliation: Department of Laboratory Medicine, Manmohan Memorial Medical College and Teaching Hospital, Kathmandu, Nepal.
authors.forename: Puspa Raj
authors.initials: PR
authors.lastname: Khanal
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001426:Bacterial Proteins / Q000235:genetics; D003430:Cross-Sectional Studies; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics; D004755:Enterobacteriaceae / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D004756:Enterobacteriaceae Infections / Q000188:drug therapy / Q000382:microbiology; D004926:Escherichia coli / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D005838:Genotype; D006784:Hospitals, Teaching; D006801:Humans; D007709:Klebsiella / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification; D007710:Klebsiella Infections / Q000188:drug therapy / Q000382:microbiology; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009390:Nepal; D055815:Young Adult; D001618:beta-Lactamases / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D001618:beta-Lactamases