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Gram-negative isolates producing carbapenemase enzymes is a great public health problem in developing countries and their control is challenging task due to the involvement of multiple factors including the practice of self-medication, use of antibiotics on animal farms, poor hospital hygiene, etc. During this study, we searched various databases for relevant publication on carbapenemase-producing isolates in Nepal. Various classes of carbapenemases had been reported in Nepal. Most frequent was the New Delhi Metallo beta lactamase with many variants where NDM-1 was most prevalent. Similarly, Oxacillinase and Klebsiella pneumoniae carbapenemase producers were also prevalent in Nepal. While other carbapenemases like VIM, IPM, and DIM also detected. The isolates producing carbapenemases were extremely drug-resistant as they also co-produced various other carbapenemases, beta-lactamases, 16S rRNA methylase. Most isolates were resistant to many members of carbapenem, cephalosporin, quinolone, penicillin, aminoglycoside group of antibiotics. Such isolates had very few treatment options as only last line drugs like colistin, fosfomycin, and tigecycline was effective against most of these isolates. Carbapenemase production by almost all major human pathogens including E. coli, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter. Citrobacter, Proteus, Providencia is a matter of concern because some of these enzymes are located on plasmids and pose rapid dissemination among various gram-negative pathogens. Timely surveillance for carbapenemase producers throughout the nation, their proper treatment, and proper hospital hygiene to prevent nosocomial infections by carbapenemase producers, controlled use of carbapenems, educating health care workers, students and the general public about the adverse effects of antimicrobial resistance is imminent.

The study was carried out in order to estimate the prevalence of intestinal parasitosis in school-going children in schools located in Pokhara, Nepal from November 2011 to January 2012. A total number of 100 stool samples were collected from children of ages 3 to 15 years. A questionnaire including the factors predisposing to parasitosis was filled up and parasitic examination was carried out by direct wet mount examination and concentration method using standard formal ether concentration technique. The prevalence rate was found to be 15%. Prevalence of parasitic infection was higher in girls (16%) than in boys (14%) and age group 8-12 years were found to be more suffering (17.3%) than other age groups. The occurrence of parasitic infection in symptomatic children was found to be 40% and 10% in asymptomatic children. The symptoms were found statistically significant with infestation of parasites. Intestinal infection was highest in Dalit students (20%) compared to other caste students. Prevalence of parasitic infection in other caste was 15% in Brahman, 9.5% in Newar and 9% in Chhetri. Among 15 positive cases 5 types of parasites were detected. The results showed Giardia lamblia to be the most common parasite. Occurrence of other intestinal parasites was Entamoeba histolytica (26.6%), Ascaris lumbricoides (26.6%), Trichuris trichura (6.6%) and Hook worm (6.6%). The study concluded that intestinal parasitosis is still public health problem among school going children of Pokhara valley especially among Dalit students.

The prevalence and drug resistance of the respiratory pathogens is increasing gradually in Nepal. However, their detail study is rare in the western region of Nepal. Hence, this study was carried out to know the incidence and antibiotic susceptibility profile of the respiratory pathogens obtained at a tertiary care center located at Pokhara. 139 pathogens were isolated from 460 clinical samples included. Significant pathogens were Gram-negative bacteria 94 (67.62%), followed by 28 (20.15%) Candida, and Gram-positive isolates 17 (12.23%). The growth rate was significantly higher for sputum samples in comparison to throat swabs. Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter were significant Gram-negative isolates while Staphylococcus aureus, Streptococcus pneumoniae, and Streptococcus pyogenes were Gram-positive pathogens. Sensitivity rate was higher for colistin and imipenem among Gram-negative isolates while lower sensitivity was for cefepime. Vancomycin was effective against all tested Gram-positive isolates while erythromycin and ciprofloxacin were less effective.

Antimicrobial resistance among food animal isolates is increasing as a result of their uncontrolled uses. The monitoring of antibiotic resistance among these isolates is very necessary. S aureus was isolated from eggshells and chicken meat samples collected from different retail outlets of the Pokhara metropolitan. Samples were inoculated on Mannitol salt agar aseptically and inoculated overnight. Isolated yellow colonies were further examined by Gram-staining, catalase, and coagulase test to detect S aureus. Methicillin resistance was screened using cefoxitin disc. Vancomycin minimum inhibitory concentration (MIC) of Methicillin-resistant S aureus (MRSA) isolates were determined by the agar dilution method following CLSI guidelines. 139 S aureus were isolated from 205 samples. Among them, 89 were from egg samples (out of 125 samples) and 50 from chicken (out of 80 samples). The overall prevalence of MRSA was 12.94%. Antibiotic resistance was significantly higher in MRSA isolates compared to Methicillin sensitive S aureus (MSSA) isolates. The highest rate of resistance was noted for ampicillin, amoxicillin, and erythromycin while the least resistance was noted for gentamicin and amikacin. Vancomycin minimum inhibitory concentration (MIC) range of the MRSA isolates was 0.25-8μg/ml indicating the detection of both vancomycin-intermediate and sensitive isolates from the samples. This is the first study reporting vancomycin-intermediate S aureus (VISA) isolates from Nepal and indicates the increasing drug resistance among animal isolates. Further surveillance studies about the transmission of these pathogens to humans as well as detail molecular analyses are imminent.