Prevalence of multidrug-resistance and blaVIM and blaIMP genes among gram-negative clinical isolates in tertiary care hospital, Kathmandu, Nepal

Background and Objectives: Carbapenems have been the choice of antibiotics for the treatment of infections caused by multidrug-resistant bacteria. The main objective of this study was to determine the prevalence of carbapenemase (blaVIM and blaIMP) producing isolates among Enterobacteriaceae, Pseudomonas aeruginosa, and Acinetobacter baumannii. Materials and Methods: A total of 1,151 clinical samples were collected from the patients visiting Annapurna Neurological Institute and Allied Science and Annapurna Research Centre, Kathmandu, between June 2017 and January 2018. Antibiotic susceptibility testing (AST) was performed on the Enterobacteriaceae, P. aeruginosa and A. baumannii isolates using the Kirby-Bauer disk diffusion method. The modified Hodge test (MHT) was performed on the carbapenem-resistant isolates to confirm carbapenemase production. DNA was extracted and then screened for blaVIM and blaIMP genes by multiplex PCR. Results: Of the total 1,151 clinical samples, 253 (22.0%) showed positive growth. Of them, 226 (89.3%) were identified as Enterobacteriaceae, P. aeruginosa, and A. baumannii. Among the 226 isolates, 106 (46.9%) were multidrug-resistant. Out of the 106, 97 (91.5%) isolates showed resistance to at least one of the carbapenem used. Among the 97 carbapenem-resistant isolates, 67 (69.1%) showed the modified Hodge test (MHT) positive results. blaVIM and blaIMP were detected in 40 and 38 isolates respectively using multiplex PCR assay. Conclusion: This study determined a high prevalence of MDR and carbapenem resistance among Enterobacteriaceae, P. aeruginosa, and A. baumannii as detected by the presence of blaVIM and blaIMP genes. This study recommends the use of rapid and advanced diagnostic tools along with conventional phenotypic detection methods in the clinical settings for early detection and management of drug-resistant pathogens to improve treatment strategies

ネパール Kaski チク Lekhnath シ Patneri ムラ ニ オケル インリョウスイ オヨビ ドジョウ ノ チョウカン ビョウゲンセイタイ オセン ジッタイ チョウサ

In Nepal, infectious diseases are highly prevalent and are responsible for morbidity and mortality. In the year of 2008 summer (rainy) season, we investigated the status of enteropathogenic contamination of drinking water and parasitic contamination of the soil at Patneri Village in Lekhnath Municipality in Kaski District, Nepal. A total of 34 water samples were tested for enteropathogeic contamination. All 34 samples tested were positive for coliform bacilli and 68% (23/34) were positive for Escherichia coli. Of the21 soil samples collected, 10% (2/21) were positive for parasite eggs of Ascaris lumbricoides and Trichuris trichiura. Questionnaires revealed that 79% (156/197) of households were keeping some kind animals in their house and 94% (184/195) of houses had a toilet. Despite of this it was interesting to observe only human parasites eggs in the positive soil samples. These results indicated that water contamination with fecal matter is more important than soil contamination with helminth parasite eggs. Low prevalence of soil contamination with helminth parasite eggs appears to be attributed to distribution of albendazole tablets during nationwide vitamin-A program

ネパール デタールムラ ジュウミン ノ ケンコウ チョウサ ト シシュウ シッカン リカン ジョウキョウ ナラビニ シシュウビョウゲンサイキン ニ カンスル チョウサ

ネパール中央部カスキ郡・デタール村住民の生活習慣を含めた健康調査、歯科検診、歯周病原細菌に関して 調査し、以下の結果を得た。 １．う蝕罹患状況・未処置かつ重症化したう蝕歯をもつ者が多い。一人平均う蝕本数が加齢とともに増加していた。う蝕処置 をしている者が少なく、抜去している歯が多かった。 ２．歯周疾患罹患状況・歯周組織検査ではCPI：0（健全）の者はどの年代でも少なく、加齢に伴い重症化していた。・喫煙者と非喫煙者の比較では、CPI値が喫煙者の方が高く、喫煙と歯周病の関連性が示唆された。・ブラッシングの回数は2回者が最も多く、回数が多い者ほどCPI値は低値を示した。 ３．唾液潜血反応検査と歯周病原細菌検査・唾液潜血反応陽性者は95％だった。また、ブラッシング時出血自覚症状の有無と唾液潜血反応の結果は、ほぼ一致した。・歯肉に炎症ある者にPorphyromonas gingivalis （ Pg 菌）に対する血漿抗体価陽性の傾向が認められ、唾液潜血反応結果では潜血反応陽性者の Pg 菌に対する血漿抗体価は陰性の傾向が認められた。このことから、この地域の歯周病罹患率ならびにう蝕罹患率は高く、重症化していることが示唆された。A health check including an interview about life habits, dental checkup and investigation of periodontopathic bacteria of periodontal disease among the residents of Dhital village, Kaski District,Nepal was conducted. The results are as follows: １．Prevalence of dental caries・There were many residents who had serious tooth decay resulting from lerving it untreated.The average number of tooth decay has increased with aging.There were not many people who treated their tooth decay,and many of their teeth were extracted. ２．Prevalence of periodontal disease・The survey of periodontal tissue showed that there were only a few people with CPI:0（healthy periodontal tissue）in every generation,and prevalence rate was rising with aging.・The comparison between smokers and non-smokers showed that the average CPI values of　smokers were higher than that of non-smokers, and it suggested a correlation between smoking and progression of periodontal disease.・There were a large number of people who brushed their teeth twice a day. The more examination they brushed their teeth, the lower the value of average CPI became. ３．Salivary occult blood test and periodontopathic bacteria test・Positive persons of occdlt blood examination were 95%. The presence of the subjective symptom with respect to bleeding during brushing teeth almost agreed with the result of the salivary occult blood test.・A positive trend for plasma antibody value against Porphyromonas gingivalis was found among the people with gingival inflammation. As a result of reaction against salivary occult blood, there was a negative trend for the plasma antibody value against Porphyromonas gingivalis . From there results,it was suggested that among people living in thie district, prevalence of both periodontal disease and tooth decay were high,and their conditions were serious

ネパール ニ オケル トキソプラズマショウ ノ ケッセイ エキガク チョウサ

We studied the seroprevalence of anti-Toxoplasma antibodies among inhabitants of the Kathmandu Valley, Nepal (location of the capital, Kathmandu) and inhabitants of a village area in Lekhnath City, Kaski District (central Kathmandu), epal. A total of 376 serum samples were collected from apparently healthy participants. Toxoplasma antibodies (IgM and IgG) were detected by enzyme- linked fluorescent assay (ELFA). In the Kathmandu Valley, positive rates for Toxoplasma IgM and IgG antibodies were 1.4% (2/146) and 35.6% (52/146) respectively. In Lekhnath City, positive rates were 2.6% (6/230) for IgM antibodies and 60.4% for IgG antibodies, i.e., comparatively higher than those in the Kathmandu Valley. The higher prevalence of these antibodies in the Lekhnath City village area was associated with animal keeping in almost all households, while in the Kathmandu Valley only a few households kept animals. However, the seroprevalence of anti-Toxoplasma antibodies in these areas was relatively high in each case. Environmental conditions may be responsible for the transmission of Toxo- plasma parasites in both areas