High Resistance of Salmonella spp. and Shigella spp. in Blood and Stool Cultures from the Sukraraj Tropical and Infectious Disease Hospital, Kathmandu, Nepal, 2015-2019.

Anup Bastola,Jeffrey K Edwards,Saugat Shrestha,Rajan Bikram Rayamajhi,Basudev Pandey,Parmananda Bhandari,Anu Maharjan,Prajjwal Pyakurel,Pruthu Thekkur

doi:10.3390/tropicalmed6020059

Abstract

Antimicrobial resistance (AMR) is an increasing global concern, particularly in Southeast Asian countries like Nepal. The aim of this study was to determine the proportion of Salmonella spp. and Shigella spp. among culture-positive bacterial isolates in blood and stool samples from 2015 to 2019 and their AMR pattern. Routinely collected data were abstracted from medical records and laboratory electronic databases of the Sukraraj Tropical and Infectious Disease Hospital (STIDH), Kathmandu, Nepal. All culture-positive bacterial isolates from blood and stool samples were included in the study. Among 390 blood cultures positive for bacterial isolates, Salmonella spp. were isolated in 44%, with S. Typhi being the most frequent (34%). Antibiotic resistance was demonstrated among Salmonella spp. to ciprofloxacin (68%), ofloxacin (16%), amoxicillin (13%) and cotrimoxazole (5%). Of the 357 stool cultures positive for bacterial isolates, the proportion of Shigella spp. isolated was 31%. Antibiotic resistance among Shigella spp. was demonstrated to cotrimoxazole (59%), tetracycline (40%), amoxicillin (38%) and ciprofloxacin (25%). Salmonella spp. and Shigella spp. were the most predominant organisms among all the bacterial isolates in blood and stool cultures, respectively. Nalidixic acid was the antibiotic to which both Salmonella spp. and Shigella spp. were most resistant.

Highlights

These countries have undergone unprecedented economic development and are a potential hub contributing to the global spread of Antimicrobial resistance (AMR) as bacteria can be transmitted by movement of people from one region to another and through the international trade of animals and products to other parts of the globe [5]
The key findings of the study were as follows: (1) There was a higher proportion of Salmonella spp. in blood cultures among all the bacterial isolates from 2015 to 2019 (44.1%); (2) there was a greater proportion of Shigella spp
This study is important as the majority of cases of salmonellosis and shigellosis are caused by contaminated food and water, which is crucial in the context of Kathmandu V, where there is a lack of health literacy, frequent poor hand hygiene and inadequate waste management and sewage systems

Summary

Introduction

Antimicrobial resistance (AMR) is a rapidly emerging concern, affecting health systems and economies globally [1,2]. Southeast Asian countries are known to contribute to AMR secondary to multiple factors such as rapid intensification of food production systems, poorly controlled public access to antimicrobials, health practitioners, the animal health industry, irrational use of 4.0/). In recent years, these countries have undergone unprecedented economic development and are a potential hub contributing to the global spread of AMR as bacteria can be transmitted by movement of people from one region to another and through the international trade of animals and products to other parts of the globe [5]

Objectives

Methods

Discussion

Conclusion