Carriage of Extended-Spectrum- β-Lactamase- and AmpC- β-Lactamase-Producing Enterobacteriaceae (ESBL-PE) in Healthy Community and Outpatient Department (OPD) Patients in Nepal

Dipendra Kumar Mandal; Shiv Kumar Sah; Shyam Kumar Mishra; Sangita Sharma; Hari Prasad Kattel; Sanjeet Pandit; Pranav Kumar Yadav; Ujjwal Laghu; Rajani Lama; Niranjan Prasad Sah; Jeevan Bahadur Sherchand; Keshav Parajuli; Anup Bastola; Sher Bahadur Pun; Basista Prasad Rijal; Bharat Mani Pokharel

doi:10.1155/2020/5154217

Carriage of Extended-Spectrum- β-Lactamase- and AmpC- β-Lactamase-Producing Enterobacteriaceae (ESBL-PE) in Healthy Community and Outpatient Department (OPD) Patients in Nepal

Can J Infect Dis Med Microbiol. 2020 Feb 11:2020:5154217. doi: 10.1155/2020/5154217. eCollection 2020.

Authors

Dipendra Kumar Mandal^{1

2}, Shiv Kumar Sah³, Shyam Kumar Mishra⁴, Sangita Sharma⁴, Hari Prasad Kattel⁴, Sanjeet Pandit⁵, Pranav Kumar Yadav⁶, Ujjwal Laghu⁷, Rajani Lama⁴, Niranjan Prasad Sah⁴, Jeevan Bahadur Sherchand⁴, Keshav Parajuli⁴, Anup Bastola², Sher Bahadur Pun², Basista Prasad Rijal⁴, Bharat Mani Pokharel⁴

Affiliations

¹ Department of Laboratory Medicine, Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal.
² Sukraraj Tropical and Infectious Diseases Hospital, Teku, Kathmandu, Nepal.
³ Faculty of Pharmaceutical Science, Purbanchal University, Little Buddha College of Health Science, Minbhawan, Kathmandu, Nepal.
⁴ Department of Microbiology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
⁵ National Public Health Laboratory, HIV Reference Unit, Kathmandu, Nepal.
⁶ Department of Laboratory Medicine, Udaypur District Hospital, Udaypur, Nepal.
⁷ Department of Microbiology, Grande International Hospital, Kathmandu, Nepal.

Abstract

Background: Extended-spectrum β-lactamase (ESBL)- and AmpC-β-lactamase (ESBL)- and AmpC-Enterobacteriaceae have recently emerged as a public threat in the treatment of nosocomial as well as community-acquired infections. Very little information is currently available about its existence in Nepal. We, therefore, aim to determine the prevalence of ESBL and AmpC-β-lactamase (ESBL)- and AmpC-Enterobacteriaceae have recently emerged as a public threat in the treatment of nosocomial as well as community-acquired infections. Very little information is currently available about its existence in Nepal. We, therefore, aim to determine the prevalence of ESBL and AmpC.

Methods: During a 6-month period (November 2014-April 2015), a total of 190 stool specimens from 190 participants were obtained from different population. Of the total 260 fecal isolates, 152 from outpatient department (OPD) and 108 from healthy volunteer were collected. Stool specimens were cultured and enterobacterial isolates were subjected to antimicrobial susceptibility tests according to the standard microbiologic guidelines. ESBL was screened using ceftazidime (CAZ, 30 μg) and cefotaxime (CTX, 30 μg) and cefotaxime (CTX, 30 β-lactamase (ESBL)- and AmpC.

Results: The prevalence of ESBL, AmpC-β-lactamase (ESBL)- and AmpC-β-lactamase (ESBL)- and AmpC-Enterobacteriaceae have recently emerged as a public threat in the treatment of nosocomial as well as community-acquired infections. Very little information is currently available about its existence in Nepal. We, therefore, aim to determine the prevalence of ESBL and AmpC-E. coli was 70.2% followed by K. pneumoniae (12.7%), and among AmpC-β-lactamase (ESBL)- and AmpC-E. coli was 70.2% followed by E. coli was 70.2% followed by K. pneumoniae (12.7%), and among AmpC-K. pneumoniae (12.7%), and among AmpC-C. freundii 2/7 (28.57%) were detected highest among AmpC-β-lactamase (ESBL)- and AmpC.

Conclusion: Our study revealed a high prevalence of ESBL- and AmpC-β-lactamase-producing enteric pathogen in Nepalese OPD and healthy population. The significant increase of these isolates and increased rate of drug resistance indicates a serious threat that stress the need to implement the surveillance system and a proper control measure so as to limit the spread of ESBL-producing Enterobacteriaceae (ESBL-PE) in both OPD as well as in community. Therefore, healthcare providers need to be aware that ESBL- and AmpC-β-lactamase-producing strains are not only circulating in hospital environments but also in the community and should be dealt with accordingly.β-lactamase (ESBL)- and AmpC-Enterobacteriaceae have recently emerged as a public threat in the treatment of nosocomial as well as community-acquired infections. Very little information is currently available about its existence in Nepal. We, therefore, aim to determine the prevalence of ESBL and AmpC-β-lactamase (ESBL)- and AmpC.