Background: Methicillin resistant Staphylococcus aureus (MRSA) is a major cause of nosocomial and community infections. Its prevalence varies with country and with hospitals within a country. The current study estimates the prevalence of MRSA strains and investigates their antibiogram in western Nepal. Methodology: A total of 162 S. aureus strains were isolated from various clinical specimens, and antibiotic susceptibility tests were performed using disc diffusion, growth on oxacillin screen agar, and oxacillin minimum inhibitory concentration (MIC). Results: One hundred and twelve (69.1%) strains were found to be MRSA, of which 37 (33.1%) were community acquired and 75 (66.9%) were hospital acquired. Of 112 MRSA strains, 45 (40.1%) were multi-drug resistant. All MRSA strains were found resistant to penicillin, and 91.9%, 87.4%, 77%, and 55.5% were resistant to amoxicillin, ampicillin, trimethoprim/sulfamethoxazole, and cephalexin, respectively. However, low resistance was observed with amikacin (19%), ciprofloxacin (26.5%), and norfloxacin (30.6%). All strains were sensitive to vancomycin. Conclusion: The reported rate of MRSA prevalence is alarming. Given the ability of MRSA to spread from person to person, it is necessary to adhere to rational use of antibiotics and to raise awareness among the concerned communities and tourists who visit this area.

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S.paucimobilis has a diverse nutritional substrate spectrum and found in both environmental and hospital settings. Sphingomonas paucimobilis is rarely isolated from clinical specimen. This low virulence organism since has been reported to cause a variety of diseases since 1979. It has been reported to be associated with both community acquired and nosocomial diseases including bacteremia, catheter related sepsis, diarrhoeal diseases, peritonitis, meningitis, cutaneous infections, endopthalmitis, visceral infections , urinary tract infections etc. We report two cases of community acquired primary bacteremia by Sphingomonas paucimobilis. One of the patients was 55-year-old female who had gallbladder carcinoma and the other was a 2-year-old healthy male who had no history of any underlying disease. Both got admission in hospital with complaints of pyrexia. Blood culture yielded S.paucimobilis which was found to be sensitive to quinolones, chloramphenicol, carbapenems, aminoglycosides and beta lactams except penicillin and amoxicillin.

Aeromonas salmonicida belonging to the genus Aeromonas, is a common pathogen that causes furunculosis and septicaemia in variety of fishes. It infects cold blooded vertebrates living at low temperatures mainly salmonid fish hence named salmonicida. Untill recently Aeromanas salmonicida is considered to be a fish pathogen. A. salmonicida is considered to be non-pathogenic for humans as it cannot grow at 37ºC. "However, In our laboratory culture plates and broths were incubated twice at 37ºC and each time same type of colonies were isolated which were identified as A. samonicida by Vitek 2 compact system bioMerieux, Inc. (Durham, N.C.)". By far no report has been received regarding its isolation from humans biological sample. Here we present the first report of A. salmonicida isolated from the human blood.

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Protozoal infections are common in the tropics. Amoebic colitis is the commonest of these infections and can lead to liver abscess as a complication. Balantidium coli is a rare free moving protozoal parasite which is known to infest human large intestine causing a type of colitis very similar to that caused by Entamoeba histolytica. However this pathogen is not known to cause liver invasion in humans. We report here a case of liver abscess caused by B. coli, which is probably the first such case reported in Indian literature.

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