Blood stream infections among febrile patients attending a teaching hospital in Western Region of Nepal

Joshy M. Easow, Noyal M. Joseph, Banodita A. Dhungel, Bipin Chapagain, P. G. Shivananda

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Blood stream infections (BSIs) are important determinants for prolonged hospital stay and if uncontrolled, progress to become life-threatening. The aim of this study is to determine the common bacterial agents associated with BSI and their antimicrobial susceptibility patterns in a tertiary care teaching hospital in the Western region of Nepal. Method: A cross-sectional study was conducted for a 20 month period from January 2006 to August 2007. All adult patients with fever (temperature ≥ 38°C) when assessed in the outpatient department or various inpatient wards were enrolled in the study. Results: Of the 933 patients with febrile illness, only 96 were diagnosed to have BSIs. Salmonella spp., Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus were the common etiological agents of BSIs. S. Paratyphi A and S. Paratyphi B were responsible for 46.7% of the enteric fever cases. The clinical diagnosis of enteric fever was not sensitive and specific. The members of Enterobacteriaceae were frequently resistant to ampicillin, amoxicillin/ clavulanic acid and gentamicin. About one-third of the K.pneumoniae, E.coli and Enterobacter spp. produced extended-spectrum β-lactamases. The non-fermenters were unusually sensitive to most antibiotics. Conclusion: Gram-negative bacteria were the predominant causes of BSIs. The occurrence of drug resistant S. Paratyphi A is of great concern for travellers, as they are not protected with an effective vaccine. Imipenem showed good activity against Pseudomonas aeruginosa indicating lack or low level of MBL activity.

Original languageEnglish
Pages (from-to)633-637
Number of pages5
JournalAustralasian Medical Journal
Volume3
Issue number10
DOIs
Publication statusPublished - 12-10-2010
Externally publishedYes

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Nepal
Teaching Hospitals
Fever
Infection
Typhoid Fever
Pseudomonas aeruginosa
Escherichia coli
Amoxicillin-Potassium Clavulanate Combination
Enterobacter
Imipenem
Klebsiella pneumoniae
Enterobacteriaceae
Tertiary Healthcare
Ampicillin
Gentamicins
Gram-Negative Bacteria
Salmonella
Staphylococcus aureus
Inpatients
Length of Stay

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Easow, Joshy M. ; Joseph, Noyal M. ; Dhungel, Banodita A. ; Chapagain, Bipin ; Shivananda, P. G. / Blood stream infections among febrile patients attending a teaching hospital in Western Region of Nepal. In: Australasian Medical Journal. 2010 ; Vol. 3, No. 10. pp. 633-637.
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abstract = "Background: Blood stream infections (BSIs) are important determinants for prolonged hospital stay and if uncontrolled, progress to become life-threatening. The aim of this study is to determine the common bacterial agents associated with BSI and their antimicrobial susceptibility patterns in a tertiary care teaching hospital in the Western region of Nepal. Method: A cross-sectional study was conducted for a 20 month period from January 2006 to August 2007. All adult patients with fever (temperature ≥ 38°C) when assessed in the outpatient department or various inpatient wards were enrolled in the study. Results: Of the 933 patients with febrile illness, only 96 were diagnosed to have BSIs. Salmonella spp., Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus were the common etiological agents of BSIs. S. Paratyphi A and S. Paratyphi B were responsible for 46.7{\%} of the enteric fever cases. The clinical diagnosis of enteric fever was not sensitive and specific. The members of Enterobacteriaceae were frequently resistant to ampicillin, amoxicillin/ clavulanic acid and gentamicin. About one-third of the K.pneumoniae, E.coli and Enterobacter spp. produced extended-spectrum β-lactamases. The non-fermenters were unusually sensitive to most antibiotics. Conclusion: Gram-negative bacteria were the predominant causes of BSIs. The occurrence of drug resistant S. Paratyphi A is of great concern for travellers, as they are not protected with an effective vaccine. Imipenem showed good activity against Pseudomonas aeruginosa indicating lack or low level of MBL activity.",
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Blood stream infections among febrile patients attending a teaching hospital in Western Region of Nepal. / Easow, Joshy M.; Joseph, Noyal M.; Dhungel, Banodita A.; Chapagain, Bipin; Shivananda, P. G.

In: Australasian Medical Journal, Vol. 3, No. 10, 12.10.2010, p. 633-637.

Research output: Contribution to journalArticle

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