Papers by Hiramani Parajuli
Prevalence of Extended Spectrum Beta-Lactamase Producing Klebsiella Pneumoniae Isolated From Urinary Tract Infected Patients
DOAJ (DOAJ: Directory of Open Access Journals), May 1, 2016
ASIAN JOURNAL OF ALLIED HEALTH SCIENCES, 2021
Proteus infect various anatomical sites with equal infection propensity in both community and hos... more Proteus infect various anatomical sites with equal infection propensity in both community and hospital environment. Proteus is usually associated with infection of respiratory tract, urinary tract, eye, ear, nose ,skin, burns, throat and wounds
{'en_US': 'Detection of Pyuria by Microscopic Urinalysis as a Marker of Pediatric Urinary Tract Infection'}
DOAJ (DOAJ: Directory of Open Access Journals), Dec 1, 2019
Nepal journal of biotechnology, Jul 31, 2021
Avian/Bird flu is a viral disease of birds, caused by avian influenza virus (AIV). A highly patho... more Avian/Bird flu is a viral disease of birds, caused by avian influenza virus (AIV). A highly pathogenic avian influenza (HPAI) H5N1 has breached the barrier of species to humans and other animals escalating the pandemic threat. If the H5N1 evolves to a human-to-human transmissible virus retaining its pathogenicity, it can trigger an influenza pandemic. H5N1 has a mortality rate of about 60%, varying with strains. Meaningful antigenic alteration in hemagglutinin (HA) and/or neuraminidase (NA) results in recurring pandemics. The HPAI H5N1 subtype alone has outreached more than 77 nations around the world since the first human case and death was reported in 1997. Wild and migratory birds are the AIV reservoirs. Poultry is primarily impacted by incidents and outbreaks of the disease. A wide range of serological and molecular methods have substantially aided in the identification of bird flu in humans. Candidate vaccines have been developed, yet are not ready for widespread use. Oseltamivir (brand name: Tamiflu) is the preferred drug for the management of human Influenzalike illness (ILI). Surveillance, mass awareness, and pandemic preparedness abiding WHO recommendations are of paramount importance for the prevention of bird flu outbreaks.
Journal of Nepal Health Research Council, 2018
Background: The study was designed to provide account of etiological agents of urinary tract infe... more Background: The study was designed to provide account of etiological agents of urinary tract infection in pediatric patients and the antimicrobial resistance pattern plus biofilm producing profile of the isolates.Methods: The prospective study was conducted in Alka Hospital, Nepal with 353 clean catch urine samples from children. It was obtained during July 2014 to January 2015 which were first cultured by semi-quantitative method, followed by antimicrobial susceptibility testing and biofilm production assay on Congo red agar. Multidrug- resistance, extensively drug- resistance and pandrug- resistance among isolates were considered as per international consensus.Results: Out of 353 samples, 64 (18.13%) showed positive growth in culture, confirming urinary tract infection. E. coli, 44 (68.8%) was the predominant organism followed by Klebsiella spp. 6 (14.1%). Most E. coli were sensitive to amikacin (93.2%) followed by nitrofurantoin (86.4%), and highly resistant to ampicillin (95.5%)...
Abstract: Background: The intestinal coccidian protozoa Cyclospora cayetanensis has emerged as a... more Abstract: Background: The intestinal coccidian protozoa Cyclospora cayetanensis has emerged as an important cause of parasitic diarrhea among children living in developing countries. This study aimed to determine the prevalence of Cyclospora among the school children of Kathmandu with reference to various associated risk factors. Methodology: A total of five hundred and seven stool samples from students between the age of 3–14 years, studying in 13 different schools in Kathmandu were collected during the study period (May–November, 2014) and processed at the Public Health Research Laboratory, Institute of Medicine, Kathmandu, Nepal. A modified acid fast staining technique (Kinyoun’s method) was used to detect oocyst of Cyclospora from the formal-ether concentrated stool samples. Results: Cyclospora was detected in 3.94 % (20/507) of the stool samples examined. The prevalence was found to be highest among the students in the 3–5 year age group i.e. 10.15 % (13/128), peaking during t...
Nepal Journal of Biotechnology
Avian/Bird flu is a viral disease of birds, caused by avian influenza virus (AIV). A highly patho... more Avian/Bird flu is a viral disease of birds, caused by avian influenza virus (AIV). A highly pathogenic avian influenza (HPAI) H5N1 has breached the barrier of species to humans and other animals escalating the pandemic threat. If the H5N1 evolves to a human-to-human transmissible virus retaining its pathogenicity, it can trigger an influenza pandemic. H5N1 has a mortality rate of about 60%, varying with strains. Meaningful antigenic alteration in hemagglutinin (HA) and/or neuraminidase (NA) results in recurring pandemics. The HPAI H5N1 subtype alone has outreached more than 77 nations around the world since the first human case and death was reported in 1997. Wild and migratory birds are the AIV reservoirs. Poultry is primarily impacted by incidents and outbreaks of the disease. A wide range of serological and molecular methods have substantially aided in the identification of bird flu in humans. Candidate vaccines have been developed, yet are not ready for widespread use. Oseltamiv...
Nepal Journal of Biotechnology
Globally, different diagnostic tests of urinary tract infection (UTI) are in clinical practices. ... more Globally, different diagnostic tests of urinary tract infection (UTI) are in clinical practices. A reliable test can increase the efficiency of the healthcare system, especially in a developing country like Nepal, reducing cost and time. Thus, we accessed the possibility of pyuria detected by microscopic urinalysis as a marker of pediatric UTI. The prospective study was conducted fromJuly2014 to January 2015 at Alka hospital, Lalitpur. Microscopic urinalysis of 353clean-catch urine samples was done by the wet mount method, followed by urine culture by a semi-quantitative method. We confirmed 64 (18.1%) UTI cases by culture, the gold standard for UTI diagnosis. Fever was the most common clinical manifestation in UTI cases. The sensitivity, specificity, positive predictive value and negative predictive value of pyuria detected by microscopic urinalysis to identify UTI were 50%, 70.9%, 27.6% and 86.5% respectively. In 318 febrile cases, the sensitivity, specificity, positive predictive...
Tropical Medicine and Health, 2015
Background: The intestinal coccidian protozoa Cyclospora cayetanensis has emerged as an important... more Background: The intestinal coccidian protozoa Cyclospora cayetanensis has emerged as an important cause of parasitic diarrhea among children living in developing countries. This study aimed to determine the prevalence of Cyclospora among the school children of Kathmandu with reference to various associated risk factors. Methodology: A total of five hundred and seven stool samples from students between the age of 3-14 years, studying in 13 different schools in Kathmandu were collected during the study period (May-November, 2014
Background: The study was designed to provide account of etiological agents of urinary tract infe... more Background: The study was designed to provide account of etiological agents of urinary tract infection in pediatric patients and the antimicrobial resistance pattern plus biofilm producing profile of the isolates.
Methods: The prospective study was conducted in Alka Hospital, Nepal with 353 clean catch urine samples from children. It was obtained during July 2014 to January 2015 which were first cultured by semi-quantitative method, followed by antimicrobial susceptibility testing and biofilm production assay on Congo red agar. Multidrug- resistance, extensively drug- resistance and pandrug- resistance among isolates were considered as per international consensus.
Results: Out of 353 samples, 64 (18.13%) showed positive growth in culture, confirming urinary tract infection. E. coli, 44 (68.8%) was the predominant organism followed by Klebsiella spp. 6 (14.1%). Most E. coli were sensitive to amikacin (93.2%) followed by nitrofurantoin (86.4%), and highly resistant to ampicillin (95.5%). Of 64 isolates, 23 (35.93%) were found to be multidrug- resistant strains. Biofilm was produced by 36 (56.25%) isolates.
Conclusions: This study showed higher biofilm production and resistance to in-use antibiotics rendering ineffective for empirical use. Regular surveillance of resistance patterns should be done to regulate multidrug- resistant bugs and to ensure effective management of urinary tract infection in children in a tertiary care setups.
Keywords: AMR; antimicrobial resistance; biofilm; urinary tract infection; UTI.
A hospital based surveillance of metallo-beta-lactamase producing gram negative bacteria in Nepal by imipenem-EDTA disk method
Background: A rising threat of the rapid spread of acquired metallo-beta-lactamases (MBLs) among ... more Background: A rising threat of the rapid spread of acquired metallo-beta-lactamases (MBLs) among major Gram-negative pathogens is a matter of public health concern worldwide. Hence, for a low income nation like Nepal, surveillance data on MBL producing clinical isolates via a cost effective technique is necessary to prevent their dissemination as well as formulation and regulation of antimicrobial stewardship policy. Methods: The prospective study was conducted at Nepal Medical College, Kathmandu from May to October, 2014 to assess the prevalence of MBL production among ceftazidime-resistant Gram-negative rods (GNRs) isolates. The samples were processed according to standard microbiological procedure following the Manual of clinical Microbiology. Isolated GNRs were subjected to susceptibility testing against the selected panel of antibiotics by Kirby-Bauer disc diffusion method and interpretation made in conformity with the Clinical and Laboratory Standards Institute (CLSI) guidelines. Ceftazidime-resistant isolates were subjected to the detection of MBL production by imipenem—EDTA combined disc (CD) method. Results: Among the Gram-negative isolates, 5.80% (21/362) were found to be MBL positive with Acinetobacter spp. showing the highest prevalence i.e. 85.71% (18/21), followed by P. aeruginosa i.e. 14.29% (3/21). None of the other cefazidime resistant gram negative bacteria tested were found to be positive for MBL production with all the positive isolates determined to be Multidrug resistant (MDR) strains. Conclusion: This study demonstrated a higher rate of resistance among P. aeruginosa and Acinetobacter spp. to a wide variety of antibiotic categories with an additional burden of MBL production within them, warranting a need for strict surveillance and rapid detection of MBL production among the GNRs.
Background: Klebsiella pneumoniae, one of the bacterial agents associated with urinary tract infe... more Background: Klebsiella pneumoniae, one of the bacterial agents associated with urinary tract infection has been
often implicated as a major extended spectrum beta-lactamase (ESBL) producer in last few decades. This study was
designed to assess the prevalence of ESBL producing Klebsiella pneumoniae in urinary isolates at a tertiary care
hospital in Kathmandu, Nepal, from July to December 2014.
Methods: One thousand nine hundred eighty six mid-stream urine specimens were collected aseptically from the
clinically suspected patients of urinary tract infections attending Capital Hospital and Research Center, Kathmandu.
The samples were processed following standard guidelines as recommended by American Society for Microbiology
(ASM) and the isolates including Klebsiella spp. were identified using the specific biochemical and sugar fermentation
tests recommended by ASM. Antibiotic sensitivity testing was done by modified Kirby-Bauer disk diffusion method
and interpreted following Clinical and Laboratory Standards Institute (CLSI) guidelines. Klebsiella pneumoniae
isolates showing resistance upon initial screening with ceftriaxone (30 μg) disc were then confirmed for ESBL
production by phenotypic confirmatory disc diffusion test (PCDDT) using ceftazidime (30 µg) and ceftazidime +
clavulanic acid (30 µg + 10µg) and cefotaxime (30 µg) and cefotaxime + clavulanic acid (30 µg +10µg) disc as per
CLSI guidelines.
Results: Out of a total 1986 specimens investigated, Escherichia coli was isolated in 309 (83.9%) and Klebsiella
pneumoniae in 38 (10.3%) cases. Initial screening with ceftriaxone disc revealed 18 isolates of Klebsiella pneumoniae
to be resistant. Further testing by PCDDT method confirmed 7 (18.4%) Klebsiella pneumoniae isolates to be ESBL
producers.
Conclusions: Compared to some earlier studies done in Nepal, higher prevalence of ESBL-producing Klebsiella
pneumoniae was observed warranting a national surveillance for routine monitoring of ESBL producing Klebsiella
pneumoniae isolates.
Keywords: Extended spectrum beta-lactamase (ESBL); klebsiella pneumonia; Nepal; prevalence; urinary tract
infection (UTI).
Background: Klebsiella pneumoniae, one of the bacterial agents associated with urinary tract infe... more Background: Klebsiella pneumoniae, one of the bacterial agents associated with urinary tract infection has been
often implicated as a major extended spectrum beta-lactamase (ESBL) producer in last few decades. This study was
designed to assess the prevalence of ESBL producing Klebsiella pneumoniae in urinary isolates at a tertiary care
hospital in Kathmandu, Nepal, from July to December 2014.
Methods: One thousand nine hundred eighty six mid-stream urine specimens were collected aseptically from the
clinically suspected patients of urinary tract infections attending Capital Hospital and Research Center, Kathmandu.
The samples were processed following standard guidelines as recommended by American Society for Microbiology
(ASM) and the isolates including Klebsiella spp. were identified using the specific biochemical and sugar fermentation
tests recommended by ASM. Antibiotic sensitivity testing was done by modified Kirby-Bauer disk diffusion method
and interpreted following Clinical and Laboratory Standards Institute (CLSI) guidelines. Klebsiella pneumoniae
isolates showing resistance upon initial screening with ceftriaxone (30 μg) disc were then confirmed for ESBL
production by phenotypic confirmatory disc diffusion test (PCDDT) using ceftazidime (30 µg) and ceftazidime +
clavulanic acid (30 µg + 10µg) and cefotaxime (30 µg) and cefotaxime + clavulanic acid (30 µg +10µg) disc as per
CLSI guidelines.
Results: Out of a total 1986 specimens investigated, Escherichia coli was isolated in 309 (83.9%) and Klebsiella
pneumoniae in 38 (10.3%) cases. Initial screening with ceftriaxone disc revealed 18 isolates of Klebsiella pneumoniae
to be resistant. Further testing by PCDDT method confirmed 7 (18.4%) Klebsiella pneumoniae isolates to be ESBL
producers.
Conclusions: Compared to some earlier studies done in Nepal, higher prevalence of ESBL-producing Klebsiella
pneumoniae was observed warranting a national surveillance for routine monitoring of ESBL producing Klebsiella
pneumoniae isolates.
Background: The intestinal coccidian protozoa Cyclospora cayetanensis has emerged as an important... more Background: The intestinal coccidian protozoa Cyclospora cayetanensis has emerged as an important cause of parasitic diarrhea among children living in developing countries. This study aimed to determine the prevalence of Cyclospora among the school children of Kathmandu with reference to various associated risk factors. Methodology: A total of five hundred and seven stool samples from students between the age of 3–14 years, studying in 13 different schools in Kathmandu were collected during the study period (May–November, 2014) and processed at the Public Health Research Laboratory, Institute of Medicine, Kathmandu, Nepal. A modified acid fast staining technique (Kinyoun's method) was used to detect oocyst of Cyclospora from the formal-ether concentrated stool samples. Results: Cyclospora was detected in 3.94% (20/507) of the stool samples examined. The prevalence was found to be highest among the students in the 3–5 year age group i.e. 10.15% (13/128), peaking during the rainy season (June–August). The detection rate was found to be significantly higher (p < 0.05) among children presenting with diarrheal symptoms, household keeping livestock and consumers of raw vegetables/fruits, showing a prevalence of 10.57% (11/104), 10.11% (9/89) and 7.25% (14/193) respectively. Conclusion: Consumption of untreated drinking water, fresh produce (raw fruits/vegetables) without proper washing and the presence of livestock at home were found to be predisposing factors for higher susceptibility of infection due to Cyclospora. This finding confirms the existence of a public-health issue with potentially serious consequences whereby children can be infected through exposure to oocysts in contaminated food and water and get ill as a result.
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Papers by Hiramani Parajuli
Methods: The prospective study was conducted in Alka Hospital, Nepal with 353 clean catch urine samples from children. It was obtained during July 2014 to January 2015 which were first cultured by semi-quantitative method, followed by antimicrobial susceptibility testing and biofilm production assay on Congo red agar. Multidrug- resistance, extensively drug- resistance and pandrug- resistance among isolates were considered as per international consensus.
Results: Out of 353 samples, 64 (18.13%) showed positive growth in culture, confirming urinary tract infection. E. coli, 44 (68.8%) was the predominant organism followed by Klebsiella spp. 6 (14.1%). Most E. coli were sensitive to amikacin (93.2%) followed by nitrofurantoin (86.4%), and highly resistant to ampicillin (95.5%). Of 64 isolates, 23 (35.93%) were found to be multidrug- resistant strains. Biofilm was produced by 36 (56.25%) isolates.
Conclusions: This study showed higher biofilm production and resistance to in-use antibiotics rendering ineffective for empirical use. Regular surveillance of resistance patterns should be done to regulate multidrug- resistant bugs and to ensure effective management of urinary tract infection in children in a tertiary care setups.
Keywords: AMR; antimicrobial resistance; biofilm; urinary tract infection; UTI.
often implicated as a major extended spectrum beta-lactamase (ESBL) producer in last few decades. This study was
designed to assess the prevalence of ESBL producing Klebsiella pneumoniae in urinary isolates at a tertiary care
hospital in Kathmandu, Nepal, from July to December 2014.
Methods: One thousand nine hundred eighty six mid-stream urine specimens were collected aseptically from the
clinically suspected patients of urinary tract infections attending Capital Hospital and Research Center, Kathmandu.
The samples were processed following standard guidelines as recommended by American Society for Microbiology
(ASM) and the isolates including Klebsiella spp. were identified using the specific biochemical and sugar fermentation
tests recommended by ASM. Antibiotic sensitivity testing was done by modified Kirby-Bauer disk diffusion method
and interpreted following Clinical and Laboratory Standards Institute (CLSI) guidelines. Klebsiella pneumoniae
isolates showing resistance upon initial screening with ceftriaxone (30 μg) disc were then confirmed for ESBL
production by phenotypic confirmatory disc diffusion test (PCDDT) using ceftazidime (30 µg) and ceftazidime +
clavulanic acid (30 µg + 10µg) and cefotaxime (30 µg) and cefotaxime + clavulanic acid (30 µg +10µg) disc as per
CLSI guidelines.
Results: Out of a total 1986 specimens investigated, Escherichia coli was isolated in 309 (83.9%) and Klebsiella
pneumoniae in 38 (10.3%) cases. Initial screening with ceftriaxone disc revealed 18 isolates of Klebsiella pneumoniae
to be resistant. Further testing by PCDDT method confirmed 7 (18.4%) Klebsiella pneumoniae isolates to be ESBL
producers.
Conclusions: Compared to some earlier studies done in Nepal, higher prevalence of ESBL-producing Klebsiella
pneumoniae was observed warranting a national surveillance for routine monitoring of ESBL producing Klebsiella
pneumoniae isolates.
Keywords: Extended spectrum beta-lactamase (ESBL); klebsiella pneumonia; Nepal; prevalence; urinary tract
infection (UTI).
often implicated as a major extended spectrum beta-lactamase (ESBL) producer in last few decades. This study was
designed to assess the prevalence of ESBL producing Klebsiella pneumoniae in urinary isolates at a tertiary care
hospital in Kathmandu, Nepal, from July to December 2014.
Methods: One thousand nine hundred eighty six mid-stream urine specimens were collected aseptically from the
clinically suspected patients of urinary tract infections attending Capital Hospital and Research Center, Kathmandu.
The samples were processed following standard guidelines as recommended by American Society for Microbiology
(ASM) and the isolates including Klebsiella spp. were identified using the specific biochemical and sugar fermentation
tests recommended by ASM. Antibiotic sensitivity testing was done by modified Kirby-Bauer disk diffusion method
and interpreted following Clinical and Laboratory Standards Institute (CLSI) guidelines. Klebsiella pneumoniae
isolates showing resistance upon initial screening with ceftriaxone (30 μg) disc were then confirmed for ESBL
production by phenotypic confirmatory disc diffusion test (PCDDT) using ceftazidime (30 µg) and ceftazidime +
clavulanic acid (30 µg + 10µg) and cefotaxime (30 µg) and cefotaxime + clavulanic acid (30 µg +10µg) disc as per
CLSI guidelines.
Results: Out of a total 1986 specimens investigated, Escherichia coli was isolated in 309 (83.9%) and Klebsiella
pneumoniae in 38 (10.3%) cases. Initial screening with ceftriaxone disc revealed 18 isolates of Klebsiella pneumoniae
to be resistant. Further testing by PCDDT method confirmed 7 (18.4%) Klebsiella pneumoniae isolates to be ESBL
producers.
Conclusions: Compared to some earlier studies done in Nepal, higher prevalence of ESBL-producing Klebsiella
pneumoniae was observed warranting a national surveillance for routine monitoring of ESBL producing Klebsiella
pneumoniae isolates.
Methods: The prospective study was conducted in Alka Hospital, Nepal with 353 clean catch urine samples from children. It was obtained during July 2014 to January 2015 which were first cultured by semi-quantitative method, followed by antimicrobial susceptibility testing and biofilm production assay on Congo red agar. Multidrug- resistance, extensively drug- resistance and pandrug- resistance among isolates were considered as per international consensus.
Results: Out of 353 samples, 64 (18.13%) showed positive growth in culture, confirming urinary tract infection. E. coli, 44 (68.8%) was the predominant organism followed by Klebsiella spp. 6 (14.1%). Most E. coli were sensitive to amikacin (93.2%) followed by nitrofurantoin (86.4%), and highly resistant to ampicillin (95.5%). Of 64 isolates, 23 (35.93%) were found to be multidrug- resistant strains. Biofilm was produced by 36 (56.25%) isolates.
Conclusions: This study showed higher biofilm production and resistance to in-use antibiotics rendering ineffective for empirical use. Regular surveillance of resistance patterns should be done to regulate multidrug- resistant bugs and to ensure effective management of urinary tract infection in children in a tertiary care setups.
Keywords: AMR; antimicrobial resistance; biofilm; urinary tract infection; UTI.
often implicated as a major extended spectrum beta-lactamase (ESBL) producer in last few decades. This study was
designed to assess the prevalence of ESBL producing Klebsiella pneumoniae in urinary isolates at a tertiary care
hospital in Kathmandu, Nepal, from July to December 2014.
Methods: One thousand nine hundred eighty six mid-stream urine specimens were collected aseptically from the
clinically suspected patients of urinary tract infections attending Capital Hospital and Research Center, Kathmandu.
The samples were processed following standard guidelines as recommended by American Society for Microbiology
(ASM) and the isolates including Klebsiella spp. were identified using the specific biochemical and sugar fermentation
tests recommended by ASM. Antibiotic sensitivity testing was done by modified Kirby-Bauer disk diffusion method
and interpreted following Clinical and Laboratory Standards Institute (CLSI) guidelines. Klebsiella pneumoniae
isolates showing resistance upon initial screening with ceftriaxone (30 μg) disc were then confirmed for ESBL
production by phenotypic confirmatory disc diffusion test (PCDDT) using ceftazidime (30 µg) and ceftazidime +
clavulanic acid (30 µg + 10µg) and cefotaxime (30 µg) and cefotaxime + clavulanic acid (30 µg +10µg) disc as per
CLSI guidelines.
Results: Out of a total 1986 specimens investigated, Escherichia coli was isolated in 309 (83.9%) and Klebsiella
pneumoniae in 38 (10.3%) cases. Initial screening with ceftriaxone disc revealed 18 isolates of Klebsiella pneumoniae
to be resistant. Further testing by PCDDT method confirmed 7 (18.4%) Klebsiella pneumoniae isolates to be ESBL
producers.
Conclusions: Compared to some earlier studies done in Nepal, higher prevalence of ESBL-producing Klebsiella
pneumoniae was observed warranting a national surveillance for routine monitoring of ESBL producing Klebsiella
pneumoniae isolates.
Keywords: Extended spectrum beta-lactamase (ESBL); klebsiella pneumonia; Nepal; prevalence; urinary tract
infection (UTI).
often implicated as a major extended spectrum beta-lactamase (ESBL) producer in last few decades. This study was
designed to assess the prevalence of ESBL producing Klebsiella pneumoniae in urinary isolates at a tertiary care
hospital in Kathmandu, Nepal, from July to December 2014.
Methods: One thousand nine hundred eighty six mid-stream urine specimens were collected aseptically from the
clinically suspected patients of urinary tract infections attending Capital Hospital and Research Center, Kathmandu.
The samples were processed following standard guidelines as recommended by American Society for Microbiology
(ASM) and the isolates including Klebsiella spp. were identified using the specific biochemical and sugar fermentation
tests recommended by ASM. Antibiotic sensitivity testing was done by modified Kirby-Bauer disk diffusion method
and interpreted following Clinical and Laboratory Standards Institute (CLSI) guidelines. Klebsiella pneumoniae
isolates showing resistance upon initial screening with ceftriaxone (30 μg) disc were then confirmed for ESBL
production by phenotypic confirmatory disc diffusion test (PCDDT) using ceftazidime (30 µg) and ceftazidime +
clavulanic acid (30 µg + 10µg) and cefotaxime (30 µg) and cefotaxime + clavulanic acid (30 µg +10µg) disc as per
CLSI guidelines.
Results: Out of a total 1986 specimens investigated, Escherichia coli was isolated in 309 (83.9%) and Klebsiella
pneumoniae in 38 (10.3%) cases. Initial screening with ceftriaxone disc revealed 18 isolates of Klebsiella pneumoniae
to be resistant. Further testing by PCDDT method confirmed 7 (18.4%) Klebsiella pneumoniae isolates to be ESBL
producers.
Conclusions: Compared to some earlier studies done in Nepal, higher prevalence of ESBL-producing Klebsiella
pneumoniae was observed warranting a national surveillance for routine monitoring of ESBL producing Klebsiella
pneumoniae isolates.