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Mishra SK, Baidya S, Bhattarai A, Shrestha S, Homagain S, Rayamajhee B, Hui A, Willcox M. Bacteriology of endotracheal tube biofilms and antibiotic resistance: a systematic review. J Hosp Infect 2024; 147:146-157. [PMID: 38522561 DOI: 10.1016/j.jhin.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 02/22/2024] [Accepted: 03/07/2024] [Indexed: 03/26/2024]
Abstract
Bacteria commonly adhere to surfaces and produce polymeric material to encase the attached cells to form communities called biofilms. Within these biofilms, bacteria can appear to be many times more resistant to antibiotics or disinfectants. This systematic review explores the prevalence and microbial profile associated with biofilm production of bacteria isolated from endotracheal tubes and its associations with antimicrobial resistance. A comprehensive search was performed on databases PubMed, Embase, and Google Scholar for relevant articles published between 1st January 2000 and 31st December 2022. The relevant articles were exported to Mendeley Desktop 1.19.8 and screened by title and abstract, followed by full text screening based on the eligibility criteria of the study. Quality assessment of the studies was performed using the Newcastle-Ottawa Scale (NOS) customized for cross-sectional studies. Furthermore, the prevalence of antimicrobial resistance in biofilm-producers isolated from endotracheal tube specimens was investigated. Twenty studies encompassing 981 endotracheal tubes met the eligibility criteria. Pseudomonas spp. and Acinetobacter spp. were predominant isolates among the biofilm producers. These biofilms provided strong resistance against commonly used antibiotics. The highest resistance rate observed in Pseudomonas spp. was against fluoroquinolones whereas the least resistance was seen against piperacillin-tazobactam. A similar trend of susceptibility was observed in Acinetobacter spp. with a very high resistance rate against fluoroquinolones, third-generation cephalosporins and carbapenems. In conclusion, endotracheal tubes were associated with colonization by biofilm forming bacteria with varying levels of antimicrobial resistance. Biofilms may promote the occurrence of recalcitrant infections in endotracheal tubes which need to be managed with appropriate protocols and antimicrobial stewardship. Research focus should shift towards meticulous exploration of biofilm-associated infections to improve detection and management.
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Affiliation(s)
- S K Mishra
- School of Optometry and Vision Science, Faculty of Health and Medicine, University of New South Wales, Sydney, Australia; Department of Microbiology, Tribhuvan University Teaching Hospital, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
| | - S Baidya
- Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - A Bhattarai
- Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - S Shrestha
- Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - S Homagain
- Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - B Rayamajhee
- School of Optometry and Vision Science, Faculty of Health and Medicine, University of New South Wales, Sydney, Australia
| | - A Hui
- School of Optometry and Vision Science, Faculty of Health and Medicine, University of New South Wales, Sydney, Australia; Center for Ocular Research and Education, School of Optometry &Vision Science, University of Waterloo, Ontario, Canada
| | - M Willcox
- School of Optometry and Vision Science, Faculty of Health and Medicine, University of New South Wales, Sydney, Australia
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Ilyas M, Stapleton F, Willcox MDP, Henriquez F, Peguda HK, Rayamajhee B, Zahid T, Petsoglou C, Carnt NA. Epidemiology of and Genetic Factors Associated with Acanthamoeba Keratitis. Pathogens 2024; 13:142. [PMID: 38392880 PMCID: PMC10892102 DOI: 10.3390/pathogens13020142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/14/2024] [Accepted: 01/31/2024] [Indexed: 02/25/2024] Open
Abstract
Acanthamoeba keratitis (AK) is a severe, rare protozoal infection of the cornea. Acanthamoeba can survive in diverse habitats and at extreme temperatures. AK is mostly seen in contact lens wearers whose lenses have become contaminated or who have a history of water exposure, and in those without contact lens wear who have experienced recent eye trauma involving contaminated soil or water. Infection usually results in severe eye pain, photophobia, inflammation, and corneal epithelial defects. The pathophysiology of this infection is multifactorial, including the production of cytotoxic proteases by Acanthamoeba that degrades the corneal epithelial basement membrane and induces the death of ocular surface cells, resulting in degradation of the collagen-rich corneal stroma. AK can be prevented by avoiding risk factors, which includes avoiding water contact, such as swimming or showering in contact lenses, and wearing protective goggles when working on the land. AK is mostly treated with an antimicrobial therapy of biguanides alone or in combination with diaminidines, although the commercial availability of these medicines is variable. Other than anti-amoeba therapies, targeting host immune pathways in Acanthamoeba disease may lead to the development of vaccines or antibody therapeutics which could transform the management of AK.
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Affiliation(s)
- Muhammad Ilyas
- Primary & Secondary Healthcare Department, Punjab 54000, Pakistan; (M.I.)
| | - Fiona Stapleton
- School of Optometry and Vision Science, University of NSW, Sydney, NSW 2052, Australia (H.K.P.)
| | - Mark D. P. Willcox
- School of Optometry and Vision Science, University of NSW, Sydney, NSW 2052, Australia (H.K.P.)
| | - Fiona Henriquez
- School of Health and Life Sciences, The University of the West of Scotland, Glasgow G72 0LH, UK
| | - Hari Kumar Peguda
- School of Optometry and Vision Science, University of NSW, Sydney, NSW 2052, Australia (H.K.P.)
| | - Binod Rayamajhee
- School of Optometry and Vision Science, University of NSW, Sydney, NSW 2052, Australia (H.K.P.)
| | - Tasbiha Zahid
- Primary & Secondary Healthcare Department, Punjab 54000, Pakistan; (M.I.)
| | | | - Nicole A. Carnt
- School of Optometry and Vision Science, University of NSW, Sydney, NSW 2052, Australia (H.K.P.)
- Centre for Vision Research, Westmead Institute for Medical Research, Sydney, NSW 2145, Australia
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Shrestha A, Ghimire S, Kinney J, Mehta R, Mistry SK, Saito S, Rayamajhee B, Sharma D, Mehta S, Yadav UN. The role of family support in the self-rated health of older adults in eastern Nepal: findings from a cross-sectional study. BMC Geriatr 2024; 24:20. [PMID: 38178009 PMCID: PMC10768249 DOI: 10.1186/s12877-023-04619-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 12/17/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Nepal's low fertility rate and increasing life expectancy have resulted in a burgeoning older population. For millennia, filial piety shaped family cohesion and helped Nepali older adults achieve positive outcomes, but recently, it has been eroding. Furthermore, there are not enough institutional support options or alternatives to family-based care to deal with the biosocial needs of older adults. This study explored the association between family support and self-rated health among Nepali older adults. METHODS A community-based cross-sectional survey in eastern Nepal's two districts, Sunsari and Morang, interviewed 847 older adults (≥ 60 years). The final analytical sample was 844. Participants were asked whether they received assistance with various aspects of daily life and activities of daily living from their families. Multivariable logistic regression examined the association between family support and self-rated health. RESULTS Participants who received support with various aspects of daily life had 43% higher odds of good health, but after adjusting for control variables, the result only approached statistical significance (p = 0.087). Those who received family assistance with activities of daily living had nearly four times higher odds (OR: 3.93; 95% CI: 2.58 - 5.98) of reporting good health than participants who lacked this support. CONCLUSIONS Given the important role of family support in Nepali older adults' health, government programs and policies should create a conducive environment to foster family-based care until more comprehensive policies for older adults' care can be put into effect. The results of this study can also help shape the global aging environment by highlighting the need for family support in older care, particularly in low-income nations with declining traditional care systems and weak social security policies.
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Affiliation(s)
- Aman Shrestha
- Department of Sociology & Gerontology and Scripps Gerontology Center, Miami University, Oxford, OH, USA
| | - Saruna Ghimire
- Department of Sociology & Gerontology and Scripps Gerontology Center, Miami University, Oxford, OH, USA
| | - Jennifer Kinney
- Department of Sociology & Gerontology and Scripps Gerontology Center, Miami University, Oxford, OH, USA
| | - Ranju Mehta
- Little Buddha College of Health Sciences, Kathmandu, Bagmati, Nepal
| | - Sabuj Kanti Mistry
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
| | - Shoko Saito
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
| | - Binod Rayamajhee
- School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW, Sydney, Australia
| | - Deepak Sharma
- School of Health Sciences, University of Tasmania, Hobart, Tasmania, Australia
| | - Suresh Mehta
- Koshi Province Ministry of Health, Biratnagar, Koshi, Nepal
| | - Uday Narayan Yadav
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia.
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT, Australia.
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Rayamajhee B, Willcox M, Sharma S, Mooney R, Petsoglou C, Badenoch PR, Sherchan S, Henriquez FL, Carnt N. Zooming in on the intracellular microbiome composition of bacterivorous Acanthamoeba isolates. ISME Commun 2024; 4:ycae016. [PMID: 38500701 PMCID: PMC10945361 DOI: 10.1093/ismeco/ycae016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/29/2023] [Accepted: 01/22/2024] [Indexed: 03/20/2024]
Abstract
Acanthamoeba, a free-living amoeba in water and soil, is an emerging pathogen causing severe eye infection known as Acanthamoeba keratitis. In its natural environment, Acanthamoeba performs a dual function as an environmental heterotrophic predator and host for a range of microorganisms that resist digestion. Our objective was to characterize the intracellular microorganisms of phylogenetically distinct Acanthamoeba spp. isolated in Australia and India through directly sequencing 16S rRNA amplicons from the amoebae. The presence of intracellular bacteria was further confirmed by in situ hybridization and electron microscopy. Among the 51 isolates assessed, 41% harboured intracellular bacteria which were clustered into four major phyla: Pseudomonadota (previously known as Proteobacteria), Bacteroidota (previously known as Bacteroidetes), Actinomycetota (previously known as Actinobacteria), and Bacillota (previously known as Firmicutes). The linear discriminate analysis effect size analysis identified distinct microbial abundance patterns among the sample types; Pseudomonas species was abundant in Australian corneal isolates (P < 0.007), Enterobacteriales showed higher abundance in Indian corneal isolates (P < 0.017), and Bacteroidota was abundant in Australian water isolates (P < 0.019). The bacterial beta diversity of Acanthamoeba isolates from keratitis patients in India and Australia significantly differed (P < 0.05), while alpha diversity did not vary based on the country of origin or source of isolation (P > 0.05). More diverse intracellular bacteria were identified in water isolates as compared with clinical isolates. Confocal and electron microscopy confirmed the bacterial cells undergoing binary fission within the amoebal host, indicating the presence of viable bacteria. This study sheds light on the possibility of a sympatric lifestyle within Acanthamoeba, thereby emphasizing its crucial role as a bunker and carrier of potential human pathogens.
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Affiliation(s)
- Binod Rayamajhee
- School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW, Sydney, NSW 2052, Australia
| | - Mark Willcox
- School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW, Sydney, NSW 2052, Australia
| | - Savitri Sharma
- Jhaveri Microbiology Centre, Prof Brien Holden Eye Research Centre, Hyderabad Eye Research Foundation, L. V. Prasad Eye Institute (LVPEI), Hyderabad, 500034, India
| | - Ronnie Mooney
- School of Health and Life Sciences, University of the West of Scotland, Blantyre, PA1 2BE, United Kingdom
| | - Constantinos Petsoglou
- Sydney and Sydney Eye Hospital, South-Eastern Sydney Local Health District, Sydney, NSW 2000, Australia
- Save Sight Institute, University of Sydney, Sydney, NSW 2000, Australia
| | - Paul R Badenoch
- College of Medicine and Public Health, Flinders University, Adelaide, 5042, Australia
| | - Samendra Sherchan
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, United States
| | - Fiona L Henriquez
- School of Health and Life Sciences, University of the West of Scotland, Blantyre, PA1 2BE, United Kingdom
| | - Nicole Carnt
- School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW, Sydney, NSW 2052, Australia
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Rayamajhee B, Willcox M, Henriquez FL, Vijay AK, Petsoglou C, Shrestha GS, Peguda HK, Carnt N. The role of naturally acquired intracellular Pseudomonas aeruginosa in the development of Acanthamoeba keratitis in an animal model. PLoS Negl Trop Dis 2024; 18:e0011878. [PMID: 38166139 PMCID: PMC10795995 DOI: 10.1371/journal.pntd.0011878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 01/18/2024] [Accepted: 12/21/2023] [Indexed: 01/04/2024] Open
Abstract
BACKGROUND Acanthamoeba is an environmental host for various microorganisms. Acanthamoeba is also becoming an increasingly important pathogen as a cause of keratitis. In Acanthamoeba keratitis (AK), coinfections involving pathogenic bacteria have been reported, potentially attributed to the carriage of microbes by Acanthamoeba. This study assessed the presence of intracellular bacteria in Acanthamoeba species recovered from domestic tap water and corneas of two different AK patients and examined the impact of naturally occurring intracellular bacteria within Acanthamoeba on the severity of corneal infections in rats. METHODOLOGY/PRINCIPAL FINDINGS Household water and corneal swabs were collected from AK patients. Acanthamoeba strains and genotypes were confirmed by sequencing. Acanthamoeba isolates were assessed for the presence of intracellular bacteria using sequencing, fluorescence in situ hybridization (FISH), and electron microscopy. The viability of the bacteria in Acanthamoeba was assessed by labelling with alkyne-functionalized D-alanine (alkDala). Primary human macrophages were used to compare the intracellular survival and replication of the endosymbiotic Pseudomonas aeruginosa and a wild type strain. Eyes of rats were challenged intrastromally with Acanthamoeba containing or devoid of P. aeruginosa and evaluated for the clinical response. Domestic water and corneal swabs were positive for Acanthamoeba. Both strains belonged to genotype T4F. One of the Acanthamoeba isolates harboured P. aeruginosa which was seen throughout the Acanthamoeba's cytoplasm. It was metabolically active and could be seen undergoing binary fission. This motile strain was able to replicate in macrophage to a greater degree than strain PAO1 (p<0.05). Inoculation of Acanthamoeba containing the intracellular P. aeruginosa in rats eyes resulted in a severe keratitis with increased neutrophil response. Acanthamoeba alone induced milder keratitis. CONCLUSIONS/SIGNIFICANCE Our findings indicate the presence of live intracellular bacteria in Acanthamoeba can increase the severity of acute keratitis in vivo. As P. aeruginosa is a common cause of keratitis, this may indicate the potential for these intracellular bacteria in Acanthamoeba to lead to severe polymicrobial keratitis.
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Affiliation(s)
- Binod Rayamajhee
- School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW, Sydney, Australia
| | - Mark Willcox
- School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW, Sydney, Australia
| | - Fiona L. Henriquez
- School of Health and Life Sciences, University of the West of Scotland, Blantyre, Scotland, United Kingdom
| | - Ajay Kumar Vijay
- School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW, Sydney, Australia
| | - Constantinos Petsoglou
- Sydney and Sydney Eye Hospital, Southeastern Sydney Local Health District, Sydney, Australia
- Save Sight Institute, University of Sydney, Sydney, Australia
| | - Gauri Shankar Shrestha
- School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW, Sydney, Australia
| | - Hari Kumar Peguda
- School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW, Sydney, Australia
| | - Nicole Carnt
- School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW, Sydney, Australia
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Rayamajhee B, Williams NLR, Siboni N, Rodgers K, Willcox M, Henriquez FL, Seymour JR, Potts J, Johnson C, Scanes P, Carnt N. Identification and quantification of Acanthamoeba spp. within seawater at four coastal lagoons on the east coast of Australia. Sci Total Environ 2023; 901:165862. [PMID: 37541500 DOI: 10.1016/j.scitotenv.2023.165862] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 07/08/2023] [Accepted: 07/26/2023] [Indexed: 08/06/2023]
Abstract
Acanthamoeba is an opportunistic free-living heterotrophic protist that is the most predominant amoeba in diverse ecological habitats. Acanthamoeba causes amoebic keratitis (AK), a painful and potentially blinding corneal infection. Major risk factors for AK have been linked to non-optimal contact lens hygiene practices and Acanthamoeba contamination of domestic and recreational water. This study investigated the incidence and seasonal variation of Acanthamoeba spp. within coastal lagoons located on the eastern coast of Australia and then examined the association between Acanthamoeba and water abiotic factors and bacterial species within the water. Water samples were collected from four intermittently closed and open lagoons (ICOLLs) (Wamberal, Terrigal, Avoca and Cockrone) every month between August 2019 to July 2020 except March and April. qPCR was used to target the Acanthamoeba 18S rRNA gene, validated by Sanger sequencing. Water abiotic factors were measured in situ using a multiprobe metre and 16S rRNA sequencing (V3-V4) was performed to characterise bacterial community composition. Network analysis was used to gauge putative associations between Acanthamoeba incidence and bacterial amplicon sequence variants (ASVs). Among 206 water samples analysed, 79 (38.3%) were Acanthamoeba positive and Acanthamoeba level was significantly higher in summer compared with winter, spring, or autumn (p = 0.008). More than 50% (23/45) water samples of Terrigal were positive for Acanthamoeba which is a highly urbanised area with extensive recreational activities while about 32% (16/49) samples were positive from Cockrone that is the least impacted lagoon by urban development. All sequenced strains belonged to the pathogenic genotype T4 clade except two which were of genotype clades T2 and T5. Water turbidity, temperature, intl1 gene concentration, and dissolved O2 were significantly associated with Acanthamoeba incidence (p < 0.05). The ASVs level of cyanobacteria, Pseudomonas spp., Candidatus spp., and marine bacteria of the Actinobacteria phylum and Acanthamoeba 18S rRNA genes were positively correlated (Pearson's r ≥ 0.14). The presence of Acanthamoeba spp. in all lagoons, except Wamberal, was associated with significant differences in the composition of bacterial communities (beta diversity). The results of this study suggest that coastal lagoons, particularly those in urbanised regions with extensive water recreational activities, may pose an elevated risk to human health due to the relatively high incidence of pathogenic Acanthamoeba in the summer. These findings underscore the importance of educating the public about the rare yet devastating impact of AK on vision and quality of life, highlighting the need for collaborative efforts between public health officials and educators to promote awareness and preventive measures, especially focusing lagoons residents and travellers.
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Affiliation(s)
- Binod Rayamajhee
- School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW, Sydney, Australia.
| | - Nathan L R Williams
- Climate Change Cluster, Faculty of Science, University of Technology Sydney, Sydney, Australia
| | - Nachshon Siboni
- Climate Change Cluster, Faculty of Science, University of Technology Sydney, Sydney, Australia
| | - Kiri Rodgers
- Institute of Biomedical and Environmental Health Research, School of Health and Life Sciences, University of the West of Scotland, Blantyre, South Lanarkshire, G72 0LH, Scotland, UK
| | - Mark Willcox
- School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW, Sydney, Australia
| | - Fiona L Henriquez
- Institute of Biomedical and Environmental Health Research, School of Health and Life Sciences, University of the West of Scotland, Blantyre, South Lanarkshire, G72 0LH, Scotland, UK
| | - Justin R Seymour
- Climate Change Cluster, Faculty of Science, University of Technology Sydney, Sydney, Australia
| | - Jaimie Potts
- Estuaries and Catchments Team, Waters Wetland Coastal Science Branch, NSW Department of Planning, Industry and Environment, Lidcombe, NSW 2141, Australia
| | - Colin Johnson
- Estuaries and Catchments Team, Waters Wetland Coastal Science Branch, NSW Department of Planning, Industry and Environment, Lidcombe, NSW 2141, Australia
| | - Peter Scanes
- Estuaries and Catchments Team, Waters Wetland Coastal Science Branch, NSW Department of Planning, Industry and Environment, Lidcombe, NSW 2141, Australia
| | - Nicole Carnt
- School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW, Sydney, Australia
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Shahzad S, Willcox MDP, Rayamajhee B. A Review of Resistance to Polymyxins and Evolving Mobile Colistin Resistance Gene ( mcr) among Pathogens of Clinical Significance. Antibiotics (Basel) 2023; 12:1597. [PMID: 37998799 PMCID: PMC10668746 DOI: 10.3390/antibiotics12111597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/26/2023] [Accepted: 11/04/2023] [Indexed: 11/25/2023] Open
Abstract
The global rise in antibiotic resistance in bacteria poses a major challenge in treating infectious diseases. Polymyxins (e.g., polymyxin B and colistin) are last-resort antibiotics against resistant Gram-negative bacteria, but the effectiveness of polymyxins is decreasing due to widespread resistance among clinical isolates. The aim of this literature review was to decipher the evolving mechanisms of resistance to polymyxins among pathogens of clinical significance. We deciphered the molecular determinants of polymyxin resistance, including distinct intrinsic molecular pathways of resistance as well as evolutionary characteristics of mobile colistin resistance. Among clinical isolates, Acinetobacter stains represent a diversified evolution of resistance, with distinct molecular mechanisms of intrinsic resistance including naxD, lpxACD, and stkR gene deletion. On the other hand, Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa are usually resistant via the PhoP-PhoQ and PmrA-PmrB pathways. Molecular evolutionary analysis of mcr genes was undertaken to show relative relatedness across the ten main lineages. Understanding the molecular determinants of resistance to polymyxins may help develop suitable and effective methods for detecting polymyxin resistance determinants and the development of novel antimicrobial molecules.
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Affiliation(s)
- Shakeel Shahzad
- School of Optometry and Vision Science, University of New South Wales, Sydney, NSW 2052, Australia;
| | - Mark D. P. Willcox
- School of Optometry and Vision Science, University of New South Wales, Sydney, NSW 2052, Australia;
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Neupane L, Sah AK, Rayamajhee B, Pokhrel A, Singh A. Detection of blaoxa-23 Gene from Carbapenem-resistant Acinetobacter Baumannii. JOURNAL OF NEPAL HEALTH RESEARCH COUNCIL 2023; 20:899-905. [PMID: 37489674 DOI: 10.33314/jnhrc.v20i4.4257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 07/20/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND Antibiotic resistance is a great concern for public health and Acinetobacter baumannii-associated infections are increasing in many parts of the world, including Nepal. However, limited data is available on the prevalence of A. baumannii harboring blaOXA-23 from Nepal. METHODS A hospital-based cross-sectional study was designed to detect the blaOXA-23 gene from carbapenem-resistant A. baumannii isolates in Nepal. A total of 380 clinical specimens were collected and processed following standard microbiological procedures. Antibiotic susceptibility test was performed as per the protocol of the Kirby-Bauer disk diffusion technique and the CLSI guidelines, while screening of carbapenemase production was assessed by the Modified Hodge Test using meropenem (10µg) disc. The presence of the blaOXA-23 gene in carbapenemase-positive A. baumannii was confirmed by PCR. RESULTS Among 380 specimens analyzed, 210 (55.3%) samples were positive for bacterial growth, where 33(15.7% of total growth) of the isolates were A. baumannii, and most of them were isolated from the ICU patients (20/33, 60.6%) and sputum (16/33, 48.5%). Thirty-two isolates (97%) were colistin sensitive, while only four (12.1%) isolates were sensitive to meropenem and imipenem. Twenty-three (69.7%) of A. baumannii were carbapenemase positive as revealed by the Modified Hodge Test test, and 19 of them (57.6% of total A. baumannii) harbored the blaOXA-23 gene. CONCLUSIONS A high prevalence of the blaOXA-23 gene among carbapenem-resistant A. baumannii isolates were found. Systematic network surveillance should be established to check the spread of such isolates, especially in the intensive care units of tertiary care hospitals in Nepal.
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Affiliation(s)
- Laxmi Neupane
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal. laxmi
| | | | - Binod Rayamajhee
- Department of Infection and Immunology, Kathmandu Research Institute for Biological Sciences (KRIBS), Lalitpur, Nepal
| | - Anil Pokhrel
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal
| | - Anjana Singh
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal
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Shrestha SK, Khadka S, Rayamajhee B, Thapa A, Sharma S, Shrestha B, Poudel P. Lower Susceptibility to Fluoroquinolones and a gyrA Gene Mutation in Salmonella Typhi Isolates from Enteric Fever Patients. J Nepal Health Res Counc 2022; 20:517-523. [PMID: 36550738 DOI: 10.33314/jnhrc.v20i02.4245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 11/03/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Enteric fever remains a major cause of morbidity and mortality in Nepal. The emergence of multi-drug resistant Salmonella is a challenge to the clinician to care for patients with enteric fever. This study assessed the antibiotic susceptibility of Salmonella Typhi isolated from enteric fever and the presence of gyrA? ?gene mutation at ser83 of S. Typhi. METHODS Blood samples (n = 834) from suspected enteric fever patients were collected and cultured to identify Salmonella Typhi. Antimicrobial sensitivity test was performed by the modified Kirby Bauer disc diffusion method. The minimum ?inhibitory concentration (MIC) tests for ofloxacin and ciprofloxacin were examined by the agar dilution method. The gyrA gene was amplified by PCR and restriction enzyme digestion was performed to evaluate the ser83 mutation. RESULTS Among 824 blood samples analyzed, 5.1% (42/824) were culture positive for S. Typhi. First-line antibiotics chloramphenicol and co-trimoxazole showed higher in-vitro efficacy compared to amoxicillin. Macrolides (azithromycin) and third-generation cephalosporins (ceftriaxone, cefixime, and cefotaxime) were highly effective against S. Typhi. Nalidixic acid resistance (NAR) was observed in 95.2% (40/42) isolates, among them, all (40/40) isolates harbored mutant gyrA gene at ser83. However, none of the nalidixic acid-sensitive Salmonella? isolates was positive for gyrA? mutation at ser83. CONCLUSIONS This study showed decreased susceptibility to fluoroquinolones and the presence of gyrA? mutation at ser83 position in majority of S. Typhi isolates which highlights the importance of alternate drugs as empirical therapy for the treatment of enteric fever patients. So, the clinician should focus on prescribing conventional first-line antibiotics for the treatment of typhoid patients after higher cohort and extended follow-up studies.
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Affiliation(s)
- Surya Kumari Shrestha
- National College, Department of Microbiology, Tribhuvan University, Kathmandu, Nepal
| | - Sujan Khadka
- Department of Microbiology, Birendra Multiple Campus, Tribhuvan University, Chitwan, Nepal
| | - Binod Rayamajhee
- Department of Infection and Immunology, Kathmandu Research Institute for Biological Sciences, Lalitpur, Nepal
| | - Alina Thapa
- Department of Microbiology, Balkumari College, Tribhuvan University, Chitwan, Nepal
| | - Suprina Sharma
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Nepal
| | - Basudha Shrestha
- Department of Microbiology, Kathmandu Model Hospital, Kathmandu, Nepal
| | - Pramod Poudel
- Central Department of Biotechnology, Tribhuvan University, Nepal
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10
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Rayamajhee B, Willcox MDP, Henriquez FL, Petsoglou C, Subedi D, Carnt N. Acanthamoeba, an environmental phagocyte enhancing survival and transmission of human pathogens. Trends Parasitol 2022; 38:975-990. [PMID: 36109313 DOI: 10.1016/j.pt.2022.08.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/10/2022] [Accepted: 08/11/2022] [Indexed: 01/13/2023]
Abstract
The opportunistic protist Acanthamoeba, which interacts with other microbes such as bacteria, fungi, and viruses, shows significant similarity in cellular and functional aspects to human macrophages. Intracellular survival of microbes in this microbivorous amoebal host may be a crucial step for initiation of infection in higher eukaryotic cells. Therefore, Acanthamoeba-microbe adaptations are considered an evolutionary model of macrophage-pathogen interactions. This paper reviews Acanthamoeba as an emerging human pathogen and different ecological interactions between Acanthamoeba and microbes that may serve as environmental training grounds and a genetic melting pot for the evolution, persistence, and transmission of potential human pathogens.
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Affiliation(s)
- Binod Rayamajhee
- School of Optometry and Vision Science, Faculty of Medicine and Health, University of New South Wales (UNSW), Sydney, Australia.
| | - Mark D P Willcox
- School of Optometry and Vision Science, Faculty of Medicine and Health, University of New South Wales (UNSW), Sydney, Australia.
| | - Fiona L Henriquez
- Institute of Biomedical and Environmental Health Research, School of Health and Life Sciences, University of the West of Scotland, Blantyre, South Lanarkshire, G72 0LH, UK
| | - Constantinos Petsoglou
- Sydney and Sydney Eye Hospital, Southeastern Sydney Local Health District, Sydney, Australia; Save Sight Institute, University of Sydney, Sydney, Australia
| | - Dinesh Subedi
- School of Biological Sciences, Monash University, Clayton, Australia
| | - Nicole Carnt
- School of Optometry and Vision Science, Faculty of Medicine and Health, University of New South Wales (UNSW), Sydney, Australia
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11
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Shrestha DB, Budhathoki P, Gurung B, Subedi S, Aryal S, Basukala A, Aryal B, Adhikari A, Poudel A, Yadav GK, Khoury M, Rayamajhee B, Shrestha LB. Epidemiology of dengue in SAARC territory: a systematic review and meta-analysis. Parasit Vectors 2022; 15:389. [PMID: 36280877 PMCID: PMC9594905 DOI: 10.1186/s13071-022-05409-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/13/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Dengue is one of the common arboviral infections and is a public health problem in South East Asia. The aim of this systematic review and meta-analysis was to evaluate the prevalence and distribution of dengue in SAARC (South Asian Association for Regional Cooperation) countries. METHODS The PubMed, PubMed Central, Embase and Scopus databases were searched for relevant studies. Statistical analysis on data extracted from the selected studied was conducted using the Comprehensive Meta-Analysis Software (CMA) version 3 software package. Proportions were used to estimate the outcome with a 95% confidence interval (CI). RESULTS Across all studies, among cases of suspected dengue, 30.7% were confirmed dengue cases (proportion: 0.307, 95% CI: 0.277-0.339). The seroprevalence of dengue immunoglobulin (Ig)G, IgM or both (IgM and IgG) antibodies and dengue NS1 antigen was 34.6, 34.2, 29.0 and 24.1%, respectively. Among the different strains of dengue, dengue virus (DENV) strains DENV-1, DENV-2, DENV-3 and DENV-4 accounted for 21.8, 41.2, 14.7 and 6.3% of cases, respectively. The prevalence of dengue fever, dengue hemorrhagic fever and dengue shock syndrome was 80.5, 18.2 and 1.5%, respectively. Fever was a commonly reported symptom, and thrombocytopenia was present in 44.7% of cases. Mortality was reported in 1.9% of dengue cases. CONCLUSIONS Dengue is a common health problem in South East Asia with high seroprevalence. DENV-2 was found to be the most common strain causing infection, and most dengue cases were dengue fever. In addition, thrombocytopenia was reported in almost half of the dengue cases.
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Affiliation(s)
| | | | | | | | | | - Anisha Basukala
- Nepalese Army Institute of Health Sciences, Kathmandu, Nepal
| | - Barun Aryal
- Department of Emergency Medicine, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - Anurag Adhikari
- Department of Emergency Medicine, Nepal National Hospital, Kathmandu, Nepal
| | - Ayusha Poudel
- Department of Emergency Medicine, Alka Hospital, Kathmandu, Nepal
| | | | - Mtanis Khoury
- Department of Internal Medicine, Mount Sinai Hospital, Chicago, IL USA
| | - Binod Rayamajhee
- School of Optometry & Vision Science, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
- Department of Infection and Immunology, Kathmandu Research Institute for Biological Sciences (KRIBS), Lalitpur, Nepal
| | - Lok Bahadur Shrestha
- Department of Microbiology & Infectious Diseases, B. P. Koirala Institute of Health Sciences, Dharan, 56700 Nepal
- School of Medical Sciences and the Kirby Institute, University of New South Wales, Sydney, Australia
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12
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Rayamajhee B, Sharma S, Willcox M, Henriquez FL, Rajagopal RN, Shrestha GS, Subedi D, Bagga B, Carnt N. Assessment of genotypes, endosymbionts and clinical characteristics of Acanthamoeba recovered from ocular infection. BMC Infect Dis 2022; 22:757. [PMID: 36175838 PMCID: PMC9520893 DOI: 10.1186/s12879-022-07741-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 09/12/2022] [Indexed: 11/22/2022] Open
Abstract
Introduction Acanthamoeba is an emerging pathogen, infamous for its resilience against antiprotozoal compounds, disinfectants and harsh environments. It is known to cause keratitis, a sight-threatening, painful and difficult to treat corneal infection which is often reported among contact lens wearers and patients with ocular trauma. Acanthamoeba comprises over 24 species and currently 23 genotypes (T1-T23) have been identified. Aims This retrospective study was designed to examine the Acanthamoeba species and genotypes recovered from patients with Acanthamoeba keratitis (AK), determine the presence of endosymbionts in ocular isolates of Acanthamoeba and review the clinical presentations. Methodology Thirteen culture-confirmed AK patients treated in a tertiary eye care facility in Hyderabad, India from February to October 2020 were included in this study. The clinical manifestations, medications and visual outcomes of all patients were obtained from medical records. The Acanthamoeba isolates were identified by sequencing the ribosomal nuclear subunit (rns) gene. Acanthamoeba isolates were assessed for the presence of bacterial or fungal endosymbionts using molecular assays, PCR and fluorescence in situ hybridization (FISH). Results The mean age of the patients was 33 years (SD ± 17.4; 95% CI 22.5 to 43.5 years). Six (46.2%) cases had AK associated risk factors; four patients had ocular trauma and two were contact lens wearers. A. culbertsoni (6/13, 46.2%) was the most common species, followed by A. polyphaga and A. triangularis. Most of the isolates (12/13) belonged to genotype T4 and one was a T12; three sub-clusters T4A, T4B, and T4F were identified within the T4 genotype. There was no significant association between Acanthamoeba types and clinical outcomes. Eight (61.5%) isolates harboured intracellular bacteria and one contained Malassezia restricta. The presence of intracellular microbes was associated with a higher proportion of stromal infiltrates (88.9%, 8/9), epithelial defect (55.6%, 5/9) and hypopyon (55.6%, 5/9) compared to 50% (2/4), 25% (1/4) and 25% (1/4) AK cases without intracellular microbes, respectively. Conclusions Genotype T4 was the predominant isolate in southern India. This is the second report of T12 genotype identified from AK patient in India, which is rarely reported worldwide. The majority of the Acanthamoeba clinical isolates in this study harboured intracellular microbes, which may impact clinical characteristics of AK. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07741-4.
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Affiliation(s)
- Binod Rayamajhee
- School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW, Sydney, Australia.
| | - Savitri Sharma
- Jhaveri Microbiology Centre, Prof. Brien Holden Eye Research Centre, Hyderabad Eye Research Foundation, L. V. Prasad Eye Institute (LVPEI), Kallam Anji Reddy Campus, Hyderabad, India
| | - Mark Willcox
- School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW, Sydney, Australia
| | - Fiona L Henriquez
- Institute of Biomedical and Environmental Health Research, School of Health and Life Sciences, University of the West of Scotland (UWS), Paisley, PA1 2BE, Scotland, UK
| | | | - Gauri Shankar Shrestha
- School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW, Sydney, Australia
| | - Dinesh Subedi
- School of Biological Sciences, Monash University, Clayton, VIC, 3800, Australia
| | - Bhupesh Bagga
- The Cornea Institute, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India
| | - Nicole Carnt
- School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW, Sydney, Australia
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13
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Magar LB, Rayamajhee B, Khadka S, Karki G, Thapa A, Yasir M, Thapa S, Panta OP, Sharma S, Poudel P. Detection of Bacillus Species with Arsenic Resistance and Plant Growth Promoting Efficacy from Agricultural Soils of Nepal. Scientifica (Cairo) 2022; 2022:9675041. [PMID: 35909656 PMCID: PMC9325649 DOI: 10.1155/2022/9675041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 05/22/2022] [Accepted: 06/01/2022] [Indexed: 06/15/2023]
Abstract
Arsenic contamination in soil and water is one of the major environmental problems in multiple countries including Nepal imposing a serious threat to the ecosystem and public health. Many soil bacteria can detoxify arsenic, including genus Bacillus. With an objective to gauge the plant growth-promoting activities of arsenic-resistant Bacillus species, 36 samples (soil, rice, cauliflower, and beans) were collected from the Terai region of Nepal. For selective isolation of Bacillus species, each sample was heated at 80°C for 15 min before the inoculation into nutrient agar (NA). Following the standard protocol, arsenic-resistant Bacillus species were screened using NA supplemented with 100 ppm sodium arsenate and sodium arsenite. Among 158 randomly selected isolates, only five isolates were able to tolerate sodium arsenite concentration up to 600 ppm. Notably, all five isolates were able to produce indole acetic acid (IAA), a plant hormone, and solubilize phosphate. Based on biochemical analysis and 16S rRNA gene sequencing, isolates N4-1, RW, KR7-12, Bhw1-4, and BW2-2 were identified as B. subtilis subsp. stercosis, B. flexus, B. licheniformis, B. cereus, and B. flexus, respectively. To the best of our knowledge, this is the first study showing the presence of arsenic-resistant B. flexus in Nepalese soil with plant growth-promoting traits. Possible utilization of these Bacillus strains could facilitate the novel bioremediation pathway to reduce the toxic effect of arsenic from the soil and water in the Terai region of Nepal.
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Affiliation(s)
- Lil Budha Magar
- Department of Microbiology, National College, Tribhuvan University, Kathmandu, Nepal
| | - Binod Rayamajhee
- School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW, Sydney, Australia
- Department of Infection and Immunology, Kathmandu Research Institute for Biological Sciences (KRIBS), Lalitpur, Nepal
| | - Sujan Khadka
- Department of Microbiology, Birendra Multiple Campus, Tribhuvan University, Bharatpur, Chitwan, Nepal
| | - Gaurab Karki
- School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW, Sydney, Australia
- Department of Biological Sciences, The University of Toledo, Toledo, Ohio, USA
| | - Alina Thapa
- Department of Microbiology, Balkumari College, Tribhuvan University, Bharatpur, Chitwan, Nepal
| | - Muhammad Yasir
- Department of Infection and Immunology, Kathmandu Research Institute for Biological Sciences (KRIBS), Lalitpur, Nepal
| | - Sandeep Thapa
- Kathmandu Center for Genomics and Research Laboratory (KCGRL), Lalitpur, Nepal
| | - Om Prakash Panta
- Department of Microbiology, National College, Tribhuvan University, Kathmandu, Nepal
| | - Suprina Sharma
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Nepal
| | - Pramod Poudel
- Research Division, University Grants Commission (UGC), Bhaktapur, Nepal
- Central Department of Biotechnology, Tribhuvan University, Kirtipur, Nepal
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14
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Bhattarai S, Adhikari A, Rayamajhee B, Dhungana J, Singh M, Koirala S, Shakya DR. Participatory Approach to Develop Evidence-Based Clinical Ethics Guidelines for the Care of COVID-19 Patients: A Mixed Method Study From Nepal. Front Public Health 2022; 10:873881. [PMID: 35832276 PMCID: PMC9272001 DOI: 10.3389/fpubh.2022.873881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 05/24/2022] [Indexed: 11/13/2022] Open
Abstract
During health emergencies such as the COVID-19 pandemic, healthcare workers face numerous ethical challenges while catering to the needs of patients in healthcare settings. Although the data recapitulating high-income countries ethics frameworks are available, the challenges faced by clinicians in resource-limited settings of low- and middle-income countries are not discussed widely due to a lack of baseline data or evidence. The Nepali healthcare system, which is chronically understaffed and underequipped, was severely affected by the COVID-19 pandemic in its capacity to manage health services and resources for needy patients, leading to ethical dilemmas and challenges during clinical practice. This study aimed to develop a standard guideline that would address syndemic ethical dilemmas during clinical care of COVID-19 patients who are unable to afford standard-of-care. A mixed method study was conducted between February and June of 2021 in 12 government designated COVID-19 treatment hospitals in central Nepal. The draft guideline was discussed among the key stakeholders in the pandemic response in Nepal. The major ethical dilemmas confronted by the study participants (50 healthcare professionals providing patient care at COVID-19 treatment hospitals) could be grouped into five major pillars of ethical clinical practice: rational allocation of medical resources, updated treatment protocols that guide clinical decisions, standard-of-care regardless of patient's economic status, effective communication among stakeholders for prompt patient care, and external factors such as political and bureaucratic interference affecting ethical practice. This living clinical ethics guideline, which has been developed based on the local evidence and case stories of frontline responders, is expected to inform the policymakers as well as the decision-makers positioned at the concerned government units. These ethics guidelines could be endorsed with revisions by the concerned regulatory authorities for the use during consequent waves of COVID-19 and other epidemics that may occur in the future. Other countries affected by the pandemic could conduct similar studies to explore ethical practices in the local clinical and public health context.
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Affiliation(s)
- Suraj Bhattarai
- Department of Global Health, Global Institute for Interdisciplinary Studies (GIIS), Kathmandu, Nepal
| | - Anurag Adhikari
- Department of Infection and Immunology, Kathmandu Research Institute for Biological Sciences (KRIBS), Lalitpur, Nepal
| | - Binod Rayamajhee
- Department of Infection and Immunology, Kathmandu Research Institute for Biological Sciences (KRIBS), Lalitpur, Nepal
- School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW, Sydney, NSW, Australia
| | - Jaya Dhungana
- Department of Global Health, Global Institute for Interdisciplinary Studies (GIIS), Kathmandu, Nepal
| | - Minu Singh
- Department of Infection and Immunology, Kathmandu Research Institute for Biological Sciences (KRIBS), Lalitpur, Nepal
| | - Sarun Koirala
- Department of Anatomy, B.P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
- Nepali Unit of International Chair in Bioethics, Dharan, Nepal
| | - Dhana Ratna Shakya
- Nepali Unit of International Chair in Bioethics, Dharan, Nepal
- Department of Psychiatry, B.P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
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15
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Shresta S, Bhandari S, Aryal B, Marasini BP, Khanal S, Poudel P, Rayamajhee B, Adhikari B, Bhattarai BR, Parajuli N. Evaluation of Phytochemical, Antioxidant and Antibacterial Activities of Selected Medicinal Plants. Nepal J Biotechnol 2021. [DOI: 10.3126/njb.v9i1.38667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Medicinal plants are important reservoirs of bioactive compounds that need to be explored systematically. Because of their chemical diversity, natural products provide limitless possibilities for new drug discovery. This study aimed to investigate the biochemical properties of crude extracts from fifteen Nepalese medicinal plants. The total phenolic contents (TPC), total flavonoid contents (TFC), and antioxidant activity were evaluated through a colorimetric approach while the antibacterial activities were studied through the measurement of the zone of inhibition (ZoI) by agar well diffusion method along with minimum inhibitory concentrations (MIC) by broth dilution method. The methanolic extracts of Acacia catechu and Eupoterium adenophorum showed the highest TPC (55.21 ± 11.09 mg GAE/gm) and TFC (10.23 ± 1.07 mg QE/gm) among the studied plant extracts. Acacia catechu showed effective antioxidant properties with an IC50 value of 1.3 μg/mL, followed by extracts of Myrica esculenta, Syzygium cumini, and Mangifera indica. Morus australis exhibited antibacterial activity against Klebsiella pneumoniae (ZoI: 25mm, MIC: 0.012 mg/mL), Staphylococcus aureus ATCC 25923 (ZoI: 22 mm, MIC: 0.012 mg/mL), Pseudomonas aeruginosa (ZoI; 20 mm, MIC: 0.05 mg/mL), and methicillin-resistant Staphylococcus aureus (MRSA) (ZoI: 19 mm, MIC: 0.19 mg/mL). Morus australis extract showed a broad-spectrum antibacterial activity, followed by Eclipta prostrata, and Hypericum cordifolium. Future study is recommended to explore secondary metabolites of those medicinal plants to uncover further clinical efficacy.
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16
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Yadav UN, Yadav OP, Singh DR, Ghimire S, Rayamajhee B, Kanti Mistry S, Rawal LB, Ali ARMM, Kumar Tamang M, Mehta S. Perceived fear of COVID-19 and its associated factors among Nepalese older adults in eastern Nepal: A cross-sectional study. PLoS One 2021; 16:e0254825. [PMID: 34310639 PMCID: PMC8312955 DOI: 10.1371/journal.pone.0254825] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 07/04/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) has affected all age groups worldwide, but older adults have been affected greatly with an increased risk of severe illness and mortality. Nepal is struggling with the COVID-19 pandemic. The normal life of older adults, one of the vulnerable populations to COVID-19 infection, has been primarily impacted. The current evidence shows that the COVID-19 virus strains are deadly, and non-compliance to standard protocols can have serious consequences, increasing fear among older adults. This study assessed the perceived fear of COVID-19 and associated factors among older adults in eastern Nepal. METHODS A cross-sectional study was conducted between July and September 2020 among 847 older adults (≥60 years) residing in three districts of eastern Nepal. Perceived fear of COVID-19 was measured using the seven-item Fear of COVID-19 Scale (FCV-19S). Multivariate logistic regression identified the factors associated with COVID-19 fear. RESULTS The mean score of the FCV-19S was 18.1 (SD = 5.2), and a sizeable proportion of older adults, ranging between 12%-34%, agreed with the seven items of the fear scale. Increasing age, Dalit ethnicity, remoteness to the health facility, and being concerned or overwhelmed with the COVID-19 were associated with greater fear of COVID-19. In contrast, preexisting health conditions were inversely associated with fear. CONCLUSION Greater fear of the COVID-19 among the older adults in eastern Nepal suggests that during unprecedented times such as the current pandemic, the psychological needs of older adults should be prioritized. Establishing and integrating community-level mental health support as a part of the COVID-19 preparedness and response plan might help to combat COVID-19 fear among them.
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Affiliation(s)
- Uday Narayan Yadav
- Centre for Primary Health Care and Equity, UNSW, Sydney, Australia
- School of Population Health, UNSW, Sydney, Australia
- Centre for Research, Policy and Implementation, Biratnagar, Nepal
- Torrens University, Sydney, Australia
- School of Health Medical and Social Sciences, Central Queensland University, Sydney, Australia
| | | | - Devendra Raj Singh
- Department of Public Health, Asian College for Advance Studies, Purbanchal University, Biratnagar, Nepal
| | - Saruna Ghimire
- Department of Sociology and Gerontology and Scripps Gerontology Center, Miami University, Oxford, OH, United States of America
| | - Binod Rayamajhee
- School of Optometry and Vision Science, Faculty of Medicine and Health Sciences, UNSW, Sydney, Australia
- Department of Infection and Immunology, Kathmandu Research Institute for Biological Sciences, Lalitpur, Nepal
| | - Sabuj Kanti Mistry
- Centre for Primary Health Care and Equity, UNSW, Sydney, Australia
- BRAC University, Dhaka, Bangladesh
| | - Lal Bahadur Rawal
- School of Health Medical and Social Sciences, Central Queensland University, Sydney, Australia
| | - ARM Mehrab Ali
- Aureolin Research, Consultancy and Expertise Development Foundation, Dhaka, Bangladesh
| | - Man Kumar Tamang
- Centre for Research, Policy and Implementation, Biratnagar, Nepal
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia
| | - Suresh Mehta
- Ministry of Health and Population, Kathmandu, Nepal
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17
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Mehata S, Tamang MK, Parajuli KR, Rayamajhee B, Yadav UN, Mehta RK, Singh DR. Serum zinc status is a matter of concern among children and non-pregnant women in a nationwide survey of Nepal. Sci Rep 2021; 11:14904. [PMID: 34290324 PMCID: PMC8295332 DOI: 10.1038/s41598-021-94344-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 07/09/2021] [Indexed: 11/15/2022] Open
Abstract
Nationally representative population data on zinc status in Nepal is lacking at present. This study analyzed data from the recent Nepal National Micronutrient status survey 2016 to determine the prevalence of zinc deficiency and associated risk factors among children aged 6–59 months (n = 1462) and non-pregnant women aged 15–49 years (n = 1923). Venous blood was collected from the participants to measure micronutrients such as zinc, markers of anemia, RBP (vitamin A), and markers of inflammation. Stool samples were collected to assess soil-transmitted helminths and Helicobacter pylori infection. Socio-demographic, household, and other relevant factors were collected by a structured questionnaire. Serum zinc concentration was measured by Microwave Plasma Atomic Emission Spectrometry, and zinc deficiency was defined according to the International Zinc Nutrition Consultative Group’s guidelines. Logistic regression was used to examine the predictors of zinc deficiency among the participants. The overall zinc deficiency in children was 22.9%, while it was higher in non-pregnant women (24.7%). The prevalence of anemia among zinc-deficient children was higher (21.3%) than the zinc non-deficit children (18.7%). The prevalence of anemia was 18% among zinc-deficient non-pregnant women compared to 22% non-deficit non-pregnant women. Predictors associated with zinc deficiency among the study children were living in rural areas (AOR = 2.25, 95% CI, [1.13, 4.49]), the occurrence of diarrhea during the two weeks preceding the survey (AOR = 1.57, 95% CI, [1.07, 2.30]), lowest household wealth quintile (AOR = 0.48, 95% CI, [0.25, 0.92]) and lower vitamin A status (AOR = 0.49, 95% CI, [0.28, 0.85]. The predictors associated with zinc deficiency among non-pregnant women were: being underweight (AOR = 1.55, 95% CI, [1.12, 2.15]), fever occurrence during two weeks preceding the survey (AOR = 1.43, 95% CI, [1.04, 1.98]), H. pylori in the stool (AOR = 1.33, 95% CI, [1.04, 1.71]), lowest household wealth quintile (AOR = 0.62, 95% CI,[0.40, 0.94]) and being at risk of folate deficiency (AOR = 0.58, 95% CI,[0.36, 0.94]). We conclude that community-level intervention programs focused on rural children and women to prevent diarrhea, improve nutrition counseling, and provide economic opportunities in rural communities may help to lower zinc deficiency and other micronutrient deficiencies in the Nepalese population. We believe that intervention programs to address zinc deficiency should not be isolated. Instead, integrated approaches are beneficial to improve overall micronutrient status, such as encouraging dietary diversity, providing livelihood opportunities to the unemployed, micronutrient supplementation to vulnerable populations, and consumption of zinc-rich animal-based foods.
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Affiliation(s)
- Suresh Mehata
- Ministry of Health and Population, Government of Nepal, Kathmandu, Nepal
| | - Man Kumar Tamang
- Center for Research Policy and Implementation, Biratnagar, Nepal. .,Queensland Brain Institute, The University of Queensland, Brisbane, Australia.
| | - Kedar Raj Parajuli
- Nutrition Section, Family Welfare Division, Department of Health Services, Ministry of Health and Population, Kathmandu, Nepal
| | - Binod Rayamajhee
- School of Optometry and Vision Science, Faculty of Health and Medicine, University of New South Wales, Sydney, Australia.,Department of Infection and Immunology, Kathmandu Research Institute for Biological Sciences (KRIBS), Lalitpur, Nepal
| | - Uday Narayan Yadav
- Center for Research Policy and Implementation, Biratnagar, Nepal.,Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia.,School of Public Health and Community Medicine, UNSW, Sydney, Australia.,Department of Public Health, Torrens University, Sydney, Australia
| | | | - Dipendra Raman Singh
- Department of Health Services, Ministry of Health and Population, Kathmandu, Nepal
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18
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Mehata S, Parajuli KR, Pant ND, Rayamajhee B, Yadav UN, Mehta RK, Jha P, Mehta N, Dhimal M, Singh DR. Prevalence and correlates of Helicobacter pylori infection among under-five children, adolescent and non-pregnant women in Nepal: Further analysis of Nepal national micronutrient status survey 2016. PLoS Negl Trop Dis 2021; 15:e0009510. [PMID: 34153049 PMCID: PMC8263064 DOI: 10.1371/journal.pntd.0009510] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/07/2021] [Accepted: 05/27/2021] [Indexed: 12/11/2022] Open
Abstract
Most of the Helicobacter pylori infections occur in developing countries. The risk factors for H. pylori infections are poverty, overcrowding, and unhygienic conditions, which are common problems in under-privileged countries such as Nepal. Despite having a high risk of H. pylori infections, no national level study has been conducted to assess prevalence and correlates of H. pylori infection in Nepal. Therefore, we hypothesized that micronutrients such as iron, vitamin B12 deficiency, socio-economic status, and nutritional status correlate with the prevalence of H. pylori infection in Nepal. We studied prevalence and correlates of H. pylori infection among under-five children, adolescents aged 10–19 years and married non-pregnant women aged 20–49 years using data from the Nepal National Micronutrient Status Survey 2016 (NNMSS-2016). H. pylori infection was examined in stool of 6–59 months old children and 20–49 years old non-pregnant women whereas the rapid diagnostic kit using blood sample was used among adolescent boys and girls. Prevalence of H. pylori infection was 18.2% among 6–59 months old children, 14% among adolescent boys and 16% among adolescent girls aged 10–19 years; and 40% among 20–49 years non-pregnant women. Poor socioeconomic status, crowding, and unhygienic condition were found to be positively associated with higher incidence of H. pylori infections. No significant correlation was observed between nutritional and micronutrients status (iron or risk of folate deficiency) with H. pylori infection. Findings from this study suggest that poverty-associated markers are primary contributors of H. pylori infections in Nepalese communities. To control acquisition and persistence of H. pylori infection in Nepal, we suggest improved management of safe drinking water and implementation of sanitation and hygiene programs, with a focus on those of lower socioeconomic status. Helicobacter pylori is associated with a wide spectrum of gastrointestinal diseases and is a common problem in tropical region where inter-human contact is the primary mode of disease transmission. Poor socio-economic status is a crucial fueling factor of H. pylori infection. In this study, the authors present data from Nepal national micronutrient status survey 2016 (NNMSS-2016) and investigated the risk factors associated with H. pylori infections among under-five years old children, 10–19 years old adolescent boys and girls, and 20–49 years non-pregnant women nationwide. Study findings corroborate that poverty-associated markers are the key driving factor of H. pylori infections in Nepal, which can have a manifold effect on nutrition and subsequent child growth retardation. Management of safe drinking water and implementation of sanitation and hygiene practices to decrease acquisition of H. pylori infection is a pressing need in rural parts of Nepal and among marginalized communities. The findings of this study highlight the varied prevalence of H. pylori by age group, gender, place of residence, ethnic group, and ecological regions of the country. Moreover, no significant correlation was observed between nutritional and micronutrients status with H. pylori infection.
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Affiliation(s)
- Suresh Mehata
- Ministry of Health and Population, Government of Nepal, Kathmandu, Nepal
- * E-mail:
| | - Kedar Raj Parajuli
- Nutrition Section, Family Welfare Division, Department of Health Services, Ministry of Health and Population, Kathmandu, Nepal
| | | | - Binod Rayamajhee
- School of Optometry and Vision Science, Faculty of Medicine and health Sciences, UNSW, Sydney, Australia
- Department of Infection and Immunology, Kathmandu Research Institute for Biological Sciences (KRIBS), Lalitpur, Nepal
| | - Uday Narayan Yadav
- Centre for Primary Health Care and Equity, UNSW, Sydney, Australia
- School of population Health, UNSW, Sydney, Australia
- Centre for Research Policy and Implementation, Biratnagar, Nepal
- Department of Public Health, Torrens University, Sydney, Australia
| | | | - Priya Jha
- Nepal Health Professional Council, Kathmandu, Nepal
| | - Neha Mehta
- Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | | | - Dipendra Raman Singh
- Department of Health Services, Ministry of Health and Population, Kathmandu, Nepal
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19
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Ghimire S, Paudel G, Mistry SK, Parvez M, Rayamajhee B, Paudel P, Tamang MK, Yadav UN. Functional status and its associated factors among community-dwelling older adults in rural Nepal: findings from a cross-sectional study. BMC Geriatr 2021; 21:335. [PMID: 34034657 PMCID: PMC8152303 DOI: 10.1186/s12877-021-02286-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 05/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The high burden of chronic conditions, coupled with various physical, mental, and psychosocial changes that accompany the phenomenon of aging, may limit the functional ability of older adults. This study aims to assess the prevalence of poor functional status and investigate factors associated with poor functional status among community-dwelling older adults in rural communities of eastern Nepal. METHODS Data on 794 older adults aged ≥ 60 years from a previous community-based cross-sectional study was used. Participants were recruited from rural municipalities of Morang and Sunsari districts of eastern Nepal using multi-stage cluster sampling. Functional status was assessed in terms of participants' ability to perform activities of daily living using the Barthel Index. Covariates included sociodemographic characteristics, lifestyle factors, and self-reported chronic conditions. A binary logistic regression model was used to investigate factors associated with poor functional status. RESULTS The overall prevalence of poor functional status was 8.3 % (male: 7.0 % and female: 9.6 %), with most dependence noted for using stairs (17.3 %), followed by dressing (21.9 %) on Barthel Index. In the adjusted model, oldest age group (odds ratio [OR] = 2.83, 95 %CI: 1.46, 5.50), those unemployed (OR = 2.41, 95 %CI: 1.26, 4.65), having memory/concentration problems (OR = 2.32, 95 %CI: 1.30, 4.13), depressive symptoms (OR = 2.52, 95 %CI: 1.28, 4.95), and hypertension (OR = 1.78, 95 %CI: 1.03, 3.06) had almost or more than two times poor functioning. CONCLUSIONS One in 12 older adults had poor functional status as indicated by their dependency on the items of the Barthel Index; those in the oldest age bracket were more likely to exhibit poor functional status. We suggest future studies from other geographies of the country to supplement our study from the rural setting for comprehensive identification of the problem, which could guide the development of prevention strategies and comprehensive interventions for addressing the unmet needs of the older adults for improving functional status.
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Affiliation(s)
- Saruna Ghimire
- Department of Sociology and Gerontology and Scripps Gerontology Center, Miami University, 45056, Oxford, OH, USA
| | - Grish Paudel
- Centre for Research Policy and Implementation, Biratnagar, Nepal
| | - Sabuj Kanti Mistry
- James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh.,Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
| | - Mahmood Parvez
- James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Binod Rayamajhee
- School of Optometry, University of New South Wales, Sydney, Australia
| | - Pravash Paudel
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Man Kumar Tamang
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia
| | - Uday Narayan Yadav
- Centre for Research Policy and Implementation, Biratnagar, Nepal. .,Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia. .,School of Population Health, University of New South Wales, Sydney, Australia. .,Torrens University, Sydney, Australia.
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20
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Rayamajhee B, Subedi D, Peguda HK, Willcox MD, Henriquez FL, Carnt N. A Systematic Review of Intracellular Microorganisms within Acanthamoeba to Understand Potential Impact for Infection. Pathogens 2021; 10:pathogens10020225. [PMID: 33670718 PMCID: PMC7922382 DOI: 10.3390/pathogens10020225] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 02/13/2021] [Accepted: 02/15/2021] [Indexed: 12/20/2022] Open
Abstract
Acanthamoeba, an opportunistic pathogen is known to cause an infection of the cornea, central nervous system, and skin. Acanthamoeba feeds different microorganisms, including potentially pathogenic prokaryotes; some of microbes have developed ways of surviving intracellularly and this may mean that Acanthamoeba acts as incubator of important pathogens. A systematic review of the literature was performed in order to capture a comprehensive picture of the variety of microbial species identified within Acanthamoeba following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Forty-three studies met the inclusion criteria, 26 studies (60.5%) examined environmental samples, eight (18.6%) studies examined clinical specimens, and another nine (20.9%) studies analysed both types of samples. Polymerase chain reaction (PCR) followed by gene sequencing was the most common technique used to identify the intracellular microorganisms. Important pathogenic bacteria, such as E. coli, Mycobacterium spp. and P. aeruginosa, were observed in clinical isolates of Acanthamoeba, whereas Legionella, adenovirus, mimivirus, and unidentified bacteria (Candidatus) were often identified in environmental Acanthamoeba. Increasing resistance of Acanthamoeba associated intracellular pathogens to antimicrobials is an increased risk to public health. Molecular-based future studies are needed in order to assess the microbiome residing in Acanthamoeba, as a research on the hypotheses that intracellular microbes can affect the pathogenicity of Acanthamoeba infections.
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Affiliation(s)
- Binod Rayamajhee
- School of Optometry and Vision Science, University of New South Wales (UNSW), Sydney, NSW 2052, Australia; (H.K.P.); (M.D.W.); (N.C.)
- Department of Infection and Immunology, Kathmandu Research Institute for Biological Sciences (KRIBS), Lalitpur 44700, Nepal
- Correspondence: or
| | - Dinesh Subedi
- School of Biological Sciences, Monash University, Clayton, VIC 3800, Australia;
| | - Hari Kumar Peguda
- School of Optometry and Vision Science, University of New South Wales (UNSW), Sydney, NSW 2052, Australia; (H.K.P.); (M.D.W.); (N.C.)
| | - Mark Duncan Willcox
- School of Optometry and Vision Science, University of New South Wales (UNSW), Sydney, NSW 2052, Australia; (H.K.P.); (M.D.W.); (N.C.)
| | - Fiona L. Henriquez
- Institute of Biomedical and Environmental Health Research, School of Health and Life Sciences, University of the West of Scotland (UWS), Paisley PA1 2BE, UK;
| | - Nicole Carnt
- School of Optometry and Vision Science, University of New South Wales (UNSW), Sydney, NSW 2052, Australia; (H.K.P.); (M.D.W.); (N.C.)
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21
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Rayamajhee B, Pokhrel A, Syangtan G, Khadka S, Lama B, Rawal LB, Mehata S, Mishra SK, Pokhrel R, Yadav UN. How Well the Government of Nepal Is Responding to COVID-19? An Experience From a Resource-Limited Country to Confront Unprecedented Pandemic. Front Public Health 2021; 9:597808. [PMID: 33681124 PMCID: PMC7925847 DOI: 10.3389/fpubh.2021.597808] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 01/21/2021] [Indexed: 12/22/2022] Open
Abstract
COVID-19, caused by SARS-CoV-2, was first reported in Wuhan, China and is now a pandemic affecting over 218 countries and territories around the world. Nepal has been severely affected by it, with an increasing number of confirmed cases and casualties in recent days, even after 8 months of the first case detected in China. As of 26 November 2020, there were over 227,600 confirmed cases of COVID in Nepal with 209,435 recovered cases and 1,412 deaths. This study aimed to compile public data available from the Ministry of Health and Population (MoHP), Government of Nepal (GoN) and analyse the data of 104 deceased COVID-19 patients using IBM SPSS (Version 25.0). Additionally, this study also aimed to provide critical insights on response of the GoN to COVID-19 and way forward to confront unprecedented pandemic. Figures and maps were created using the Origin Lab (Version 2018) and QGIS (Version 3.10.8). Most of the reported cases were from Bagmati Province, the location of Nepal's capital city, Kathmandu. Among deceased cases, >69% of the patients were male and patients ≥54 years accounted for 67.9% (n = 923). Preliminary findings showed respiratory illness, diabetes, and chronic kidney diseases were the most common comorbid conditions associated with COVID-19 deaths in Nepal. Despite some efforts in the 8 months since the first case was detected, the government's response so far has been insufficient. Since the government eased the lockdown in July 2020, Nepal is facing a flood of COVID-19 cases. If no aggressive actions are taken, the epidemic is likely to result in significant morbidity and mortality in Nepal. The best way to curb the effect of the ongoing pandemic in a resource-limited country like Nepal is to increase testing, tracing, and isolation capacity, and to set up quality quarantine centers throughout the nation. A comprehensive health literacy campaign, quality care of older adults and those with comorbidity will also result in the effective management of the ongoing pandemic.
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Affiliation(s)
- Binod Rayamajhee
- School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia
- Department of Infection and Immunology, Kathmandu Research Institute for Biological Sciences, Kathmandu, Nepal
| | - Anil Pokhrel
- Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal
| | - Gopiram Syangtan
- Shi-Gan International College of Science and Technology, Tribhuvan University, Kathmandu, Nepal
| | - Saroj Khadka
- Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal
| | - Bhupendra Lama
- Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal
| | - Lal Bahadur Rawal
- School of Health Medical and Social Sciences, Central Queensland University, Sydney, NSW, Australia
| | - Suresh Mehata
- Ministry of Health and Population (MoHP), Government of Nepal (GoN), Kathmandu, Nepal
| | - Shyam Kumar Mishra
- School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia
- Department of Microbiology, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Roshan Pokhrel
- Ministry of Health and Population (MoHP), Government of Nepal (GoN), Kathmandu, Nepal
| | - Uday Narayan Yadav
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia
- Centre for Research, Policy and Implementation, Kathmandu, Nepal
- Torrens University, Sydney, NSW, Australia
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22
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Syangtan G, Bista S, Dawadi P, Rayamajhee B, Shrestha LB, Tuladhar R, Joshi DR. Asymptomatic SARS-CoV-2 Carriers: A Systematic Review and Meta-Analysis. Front Public Health 2021; 8:587374. [PMID: 33553089 PMCID: PMC7855302 DOI: 10.3389/fpubh.2020.587374] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 12/22/2020] [Indexed: 12/19/2022] Open
Abstract
Asymptomatic cases of SARS-CoV-2 can be unknown carriers magnifying the transmission of COVID-19. This study appraised the frequency of asymptomatic individuals and estimated occurrence by age group and gender by reviewing the existing published data on asymptomatic people with COVID-19. Three electronic databases, PubMed, Embase, and Web of Science (WoS), were used to search the literature following the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). The study population for this review included asymptomatic individuals infected with SARS-CoV-2 reported in original articles published up to 30 April 2020. A random effects model was applied to analyze pooled data on the prevalence of asymptomatic cases among all COVID-19 patients and also by age and gender. From the meta-analysis of 16 studies, comprising 2,788 SARS-CoV-2 infected patients, the pooled prevalence according to the random effect size of asymptomatic cases was 48.2% (95% CI, 30-67%). Of the asymptomatic cases, 55.5% (95% CI, 43.6-66.8%) were female and 49.6% (95% CI, 20.5-79.1%) were children. Children and females were more likely to present as asymptomatic COVID-19 cases and could act as unknown carriers of SARS-CoV-2. Symptom-based screening might fail to identify all SARS-CoV-2 infections escalating the threat of global spread and impeding containment. Therefore, a mass surveillance system to track asymptomatic cases is critical, with special attention to females and children.
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Affiliation(s)
- Gopiram Syangtan
- Shi-Gan International College of Science and Technology (SICOST), Tribhuvan University, Kathmandu, Nepal
| | - Shrijana Bista
- Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal
| | - Prabin Dawadi
- Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal
| | - Binod Rayamajhee
- Faculty of Science, School of Optometry and Vision Science (SOVS), University of New South Wales (UNSW), Sydney, NSW, Australia
- Department of Infection and Immunology, Kathmandu Research Institute for Biological Sciences (KRIBS), Lalitpur, Nepal
| | - Lok Bahadur Shrestha
- Department of Microbiology and Infectious Diseases, B. P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Reshma Tuladhar
- Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal
| | - Dev Raj Joshi
- Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal
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23
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Adhikari B, Marasini BP, Rayamajhee B, Bhattarai BR, Lamichhane G, Khadayat K, Adhikari A, Khanal S, Parajuli N. Potential roles of medicinal plants for the treatment of viral diseases focusing on COVID-19: A review. Phytother Res 2020; 35:1298-1312. [PMID: 33037698 PMCID: PMC7675695 DOI: 10.1002/ptr.6893] [Citation(s) in RCA: 110] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/16/2020] [Accepted: 09/16/2020] [Indexed: 12/18/2022]
Abstract
The whole world is entangled by the coronavirus disease (COVID‐19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), people are dying in thousands each day, and without an actual medication, it seems not possible for the bringing this global health crisis to a stop. Natural products have been in constant use since ancient times and are proven by time to be effective. Crude extract or pure compounds isolated from medicinal plants and/or herbs such as Artemisia annua, Agastache rugosa, Astragalus membranaceus, Cassia alata, Ecklonia cava, Gymnema sylvestre, Glycyrrhizae uralensis, Houttuynia cordata, Lindera aggregata, Lycoris radiata, Mollugo cerviana, Polygonum multiflorum, Pyrrosia lingua, Saposhnikoviae divaricate, Tinospora cordifolia etc. have shown promising inhibitory effect against coronavirus. Several molecules, including acacetin, amentoflavone, allicin, blancoxanthone, curcumin, daidzein, diosmin, epigallocatechin‐gallate, emodin, hesperidin, herbacetin, hirsutenone, iguesterin, jubanine G, kaempferol, lycorine, pectolinarin, phloroeckol, silvestrol, tanshinone I, taxifolin, rhoifolin, xanthoangelol E, zingerol etc. isolated from plants could also be potential drug candidates against COVID‐19. Moreover, these could also show promising inhibitory effects against influenza‐parainfluenza viruses, respiratory syncytial virus, severe acute respiratory syndrome (SARS), and Middle East respiratory syndrome coronavirus (MERS‐CoV). Here, we have reported 93 antiviral drug candidates which could be a potential area of research in drug discovery.
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Affiliation(s)
- Bikash Adhikari
- Central Department of Chemistry, Tribhuvan University, Kirtipur, Nepal
| | - Bishnu P Marasini
- Department of Biotechnology, National College, Tribhuvan University, Kirtipur, Nepal
| | - Binod Rayamajhee
- School of Optometry and Vision Science, Faculty of Science, University of New South Wales (UNSW), Sydney, Australia.,Department of Infection and Immunology, Kathmandu Research Institute for Biological Sciences (KRIBS), Lalitpur, Nepal
| | | | - Ganesh Lamichhane
- Central Department of Chemistry, Tribhuvan University, Kirtipur, Nepal
| | - Karan Khadayat
- Central Department of Chemistry, Tribhuvan University, Kirtipur, Nepal.,Department of Biotechnology, National College, Tribhuvan University, Kirtipur, Nepal
| | - Achyut Adhikari
- Central Department of Chemistry, Tribhuvan University, Kirtipur, Nepal
| | - Santosh Khanal
- Department of Biotechnology, National College, Tribhuvan University, Kirtipur, Nepal
| | - Niranjan Parajuli
- Central Department of Chemistry, Tribhuvan University, Kirtipur, Nepal
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24
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Yadav UN, Rayamajhee B, Mistry SK, Parsekar SS, Mishra SK. A Syndemic Perspective on the Management of Non-communicable Diseases Amid the COVID-19 Pandemic in Low- and Middle-Income Countries. Front Public Health 2020; 8:508. [PMID: 33102414 PMCID: PMC7545493 DOI: 10.3389/fpubh.2020.00508] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 08/07/2020] [Indexed: 12/18/2022] Open
Abstract
The global coronavirus disease (COVID-19) pandemic has greatly affected the lives of people living with non-communicable diseases (PLWNCDs). The health of PLWNCDs worsens when synergistic epidemics or “syndemics” occur due to the interaction between socioecological and biological factors, resulting in adverse outcomes. These interactions can affect the physical, emotional, and social well-being of PLWNCDs. In this paper, we discuss the effects of the COVID-19 syndemic on PLWNCDs, particularly how it has exposed them to NCD risk factors and disrupted essential public health services. We conclude by reflecting on strategies and policies that deal with the COVID-19 syndemic among PLWNCDs in low- and middle-income countries.
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Affiliation(s)
- Uday Narayan Yadav
- Centre for Primary Health Care and Equity, University of New South Wales (UNSW), Sydney, NSW, Australia.,Forum for Health Research and Development, Dharan, Nepal
| | - Binod Rayamajhee
- School of Optometry and Vision Science, Faculty of Science, University of New South Wales, Sydney, NSW, Australia.,Department of Infectious Diseases and Immunology, Kathmandu Research Institute for Biological Sciences (KRIBS), Lalitpur, Nepal
| | - Sabuj Kanti Mistry
- Centre for Primary Health Care and Equity, University of New South Wales (UNSW), Sydney, NSW, Australia.,James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Shradha S Parsekar
- Public Health Evidence South Asia, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | - Shyam Kumar Mishra
- School of Optometry and Vision Science, Faculty of Science, University of New South Wales, Sydney, NSW, Australia.,Department of Microbiology, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
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25
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Khadayat K, Sherpa DD, Malla KP, Shrestha S, Rana N, Marasini BP, Khanal S, Rayamajhee B, Bhattarai BR, Parajuli N. Molecular Identification and Antimicrobial Potential of Streptomyces Species from Nepalese Soil. Int J Microbiol 2020; 2020:8817467. [PMID: 32908528 PMCID: PMC7474392 DOI: 10.1155/2020/8817467] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 08/12/2020] [Indexed: 11/20/2022] Open
Abstract
Streptomyces are widely used for the production of secondary metabolites with diverse biological activities, including antibiotics. The necessity of alternative antimicrobial agents against multidrug-resistant pathogens is indispensable. However, the production of new therapeutics is delayed in recent days. Thus, the isolation of new Streptomyces species has drawn attention. Nepal-a country rich in biodiversity-has got high possibilities for the discovery of members of actinomycetes, especially in the higher altitudes. However, in vain, only a few screening research works have been reported from Nepal to date. Streptomyces species were isolated on ISP4 media, and characterization was performed according to morphological similarity and 16S rRNA sequence similarity using bioinformatic tools. Ethyl acetate extracts of Streptomyces species were prepared, and the antimicrobial activity was carried out using agar well diffusion technique. In this report, 18 Streptomyces species isolated from the soil were reported based on sequence analysis of 16S rRNA. Among them, 12 isolates have shown antibacterial activity against extended-spectrum beta-lactamase- (ESBL-) producing Escherichia coli. Here, we have also analyzed 16S rRNA in 27 Streptomyces species whose whole-genome sequence is available, which has revealed that some species have multiple copies of the 16S gene (∼1.5 kb) with significant variation in nucleotides. In contrast, some Streptomyces species shared identical DNA sequences in multiple copies of 16S rRNA. The sequencing of numerous copies of 16S rRNA is not necessary, and the molecular sequencing of this region is not sufficient for the identification of bacterial species. The Streptomyces species-derived ethyl acetate extracts from Nepalese soil demonstrate potential activity against ESBL-producing E. coli. Thus, they are potential candidates for antibiotics manufacturing in the future.
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Affiliation(s)
- Karan Khadayat
- Central Department of Chemistry, Tribhuvan University, Kirtipur, Kathmandu, Nepal
- Department of Biotechnology, National College, Tribhuvan University, Naya Bazar, Kathmandu, Nepal
| | - Dawa Dindu Sherpa
- Department of Biotechnology, National College, Tribhuvan University, Naya Bazar, Kathmandu, Nepal
| | - Krishna Prakash Malla
- Department of Biotechnology, National College, Tribhuvan University, Naya Bazar, Kathmandu, Nepal
| | - Sunil Shrestha
- Department of Biotechnology, National College, Tribhuvan University, Naya Bazar, Kathmandu, Nepal
| | - Nabin Rana
- Department of Biotechnology, National College, Tribhuvan University, Naya Bazar, Kathmandu, Nepal
| | - Bishnu P. Marasini
- Department of Biotechnology, National College, Tribhuvan University, Naya Bazar, Kathmandu, Nepal
| | - Santosh Khanal
- Department of Microbiology, National College, Tribhuvan University, Naya Bazar, Kathmandu, Nepal
| | - Binod Rayamajhee
- Department of Microbiology, National College, Tribhuvan University, Naya Bazar, Kathmandu, Nepal
| | - Bibek Raj Bhattarai
- Central Department of Chemistry, Tribhuvan University, Kirtipur, Kathmandu, Nepal
| | - Niranjan Parajuli
- Central Department of Chemistry, Tribhuvan University, Kirtipur, Kathmandu, Nepal
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26
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Gupta R, Rayamajhee B, Sherchan SP, Rai G, Mukhiya RK, Khanal B, Rai SK. Prevalence of intestinal parasitosis and associated risk factors among school children of Saptari district, Nepal: a cross-sectional study. Trop Med Health 2020; 48:73. [PMID: 32848503 PMCID: PMC7444033 DOI: 10.1186/s41182-020-00261-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/13/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Intestinal parasitosis, caused by both helminths and protozoans, are among the most prevalent infections, especially in developing countries. Enteric parasites continue to be a major cause of parasitic diseases which is the most common among street and school going children with poor sanitation. This cross-sectional study was carried out to determine the prevalence and potential risk factors of intestinal parasitosis among school going children of two schools of Saptari district of southern Nepal. Stool samples were collected in a clean, dry, screw-capped, and wide-mouthed plastic container, fixed with 10% formal-saline solution, and transported to the laboratory for further microscopic analysis by following concentration technique. RESULTS Out of the 285 stool samples analysed, 94 (33%) were positive for the parasitosis. Presence of intestinal parasites was marginally more in rural school (44.6%) than in urban (30%) (P < 0.05). Giardia lamblia was highly prevalent (15.4%) followed by Entamoeba histolytica-like (7.7%), E. coli (7%), Ascaris lumbricoides (1.8%), and Hymenolepis nana (1.08%), respectively. Children of the age group 11-15 years were highly affected (44.2%) compared to younger age groups. The findings of intestinal parasitosis in the study population were statistically significant with family income, hand-washing habit, type of drinking water, and availability of a toilet facility at home (P < 0.05). Over 85% of infection was associated with parasitosis that indicated mainly waterborne infection rather than soil-borne helminths. CONCLUSIONS Poor hygiene measures and farming occupation are identified as major risk factors of parasitic infections, so sanitation especially focusing on safe drinking water along with multi intervention strategies must be emphasized in the Saptari district of Nepal to reduce the burden of parasitic diseases in school children.
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Affiliation(s)
- Ranjit Gupta
- ShiGan International College of Science and Technology, Kathmandu, Nepal
| | - Binod Rayamajhee
- Department of Infectious Disease and Immunology, Kathmandu Research Institute for Biological Sciences (KRIBS), Lalitpur, Nepal
- School of Optometry and Vision Science, Faculty of Science, UNSW, Sydney, NSW 2052 Australia
| | - Samendra P. Sherchan
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA USA
| | - Ganesh Rai
- ShiGan International College of Science and Technology, Kathmandu, Nepal
- National Institute of Tropical Medicine and Public Health Research, Kathmandu, Nepal
| | | | - Binod Khanal
- ShiGan International College of Science and Technology, Kathmandu, Nepal
| | - Shiba Kumar Rai
- ShiGan International College of Science and Technology, Kathmandu, Nepal
- National Institute of Tropical Medicine and Public Health Research, Kathmandu, Nepal
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Bhandari S, Rayamajhee B, Dhungel L, Poudel S, Gaire B, Shrestha S, Parajuli N. Infectious sources of Histoplasmosis and molecular techniques for its identification. Nepal J Biotechnol 2019. [DOI: 10.3126/njb.v7i1.26949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Histoplasmosis, a fungal infection caused by Histoplasma capsulatum (H. capsulatum), acquired from contaminated soil with droppings of chicken or birds and found to be distributed in many parts of the world. The prevalence of histoplasmosis has not well studied in Nepal. The common symptoms of acute and epidemic histoplasmosis include high fever, cough, and asthenia and weight loss. Most of the infections associated with histoplasmosis are asymptomatic. People with compromised immune systems such as HIV/AIDS (PLWHA), cancer, and organ transplant recipients are at risk of developing this disease. In this review, we have summarised the current status of histoplasmosis in Nepal and molecular techniques available for its identification. To date, the significant outbreak is not reported in Nepal, but the risk of infection for the vulnerable population cannot be undermined. Appropriate preventive measures and treatment on time can reduce the burden of this fungal disease. Further, this review is also focused on molecular identification of H. capsulatum. Hence, careful considerations by concerned stakeholders for national surveillance programs and the treatment of patients on time after proper diagnosis is highly recommended.
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Maharjan S, Rayamajhee B, Chhetri VS, Sherchan SP, Panta OP, Karki TB. Microbial quality of poultry meat in an ISO 22000:2005 certified poultry processing plant of Kathmandu valley. FoodContamination 2019. [DOI: 10.1186/s40550-019-0078-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
AbstractPoultry meat can be contaminated by different types of microorganisms during processing in processing plant. The microbiological quality of chicken carcasses and along with processing steps and environmental condition was analyzed in this study in an ISO 22000:2005 certified poultry processing plant of Kathmandu. Standard plate count method was applied for the enumeration and detection of total mesophilic bacteria, total coliform, total faecal coliform, Staphylococcus load along with selected pathogens like Salmonella spp., S. aureus, Escherichia coli, Clostridium perfringens, and Listeria spp. in chicken meat at four processing step (evisceration, final washing, frozen and market). It was observed that the level of microbial load decreased with subsequent processing phases in poultry processing plant where high level of bacteria were reduced during final washing and frozen phase. After processing poultry meat in an ISO 22000:2005 certified meat processing plant, total aerobic mesophilic count, total coliform count, total faecal coliform count, total Staphylococcus count were decreased from 6.92 to 4.45 log CFU/g, 3.49 to 2.19 log CFU/g, 2.41 to nil log CFU/g, and 3..43 to 1.99 log CFU/g respectively. Pathogenic bacteria like Salmonella spp., C. perfringens, and Listeria spp. were absent in chicken meat at the fourth processing step. Prevalence of E. coli was reduced from 37.4% to 10.2%, whereas S. aureus was decreased from 18.57% to 17.1%. It was concluded that the final washing and freezing steps were the Critical Control Point (CCP) to control microbial hazards in poultry processing phase.
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Jp Y, Laxman G, Rayamajhee B. Confirmation of Blandm-1 gene among the carbapenem resistant isolates from patients with meningitis symptoms attending a tertiary care hospital of Central Nepal. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Upreti N, Rayamajhee B, Sherchan SP, Choudhari MK, Banjara MR. Prevalence of methicillin resistant Staphylococcus aureus, multidrug resistant and extended spectrum β-lactamase producing gram negative bacilli causing wound infections at a tertiary care hospital of Nepal. Antimicrob Resist Infect Control 2018; 7:121. [PMID: 30338059 PMCID: PMC6174564 DOI: 10.1186/s13756-018-0408-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 09/17/2018] [Indexed: 12/21/2022] Open
Abstract
Background Treatment and prevention of wound infection continues to be a challenging issue in clinical settings of Nepal especially in the context of globally growing problem of antimicrobial resistance. Study on opportunistic pathogens and sensitivity to commonly prescribed local antimicrobial agents are cardinal to reduce the disease burden of wound infections. The aim of this study was to determine the prevalence and antimicrobial susceptibility pattern of methicillin resistant Staphylococcus aureus (MRSA) and extended spectrum β-lactamase (ESBL) producing bacteria from wound infections of patients at a tertiary care hospital in Nepal. Methods Pus specimens were processed using standard microbiological procedures. Antimicrobial susceptibility test was performed following the modified Kirby Bauer disc diffusion technique. Clinical information of patients was obtained from preformed questionnaire and hospital record. Results One hundred eighty two pus specimens from wounds of different body parts: leg, hand, backside, abdominal part, foot, breast and chest, head and neck region were collected and analyzed; 113 bacterial isolates were isolated showing the overall bacterial growth rate of 62%, where the highest rate was among patients of ≤10 years age group (82.1%). A higher rate (68.5%) of bacterial isolates were from inpatients (p < 0.05). Among 116 bacterial isolates, Staphylococcus aureus was the most predominant bacteria (56.9%) followed by Escherichia coli (8.6%), coagulase negative staphylococci (7.8%), Acinetobacter spp. (5.2%), Klebsiella pneumoniae (5.2%), Pseudomonas aeruginosa (4.3%), Enterococcus spp. (4.3%), Citrobacter freundii (2.6%), Proteus vulgaris (1.6%) and P. mirabilis (0.9%). Both Gram positive (73.3%) and negative (78.8%) isolates showed high frequency of sensitive to gentamycin. Conclusion Among S. aureus isolates, 60.6% were MRSA strains, whereas 40% of K. pneumoniae and 33.3% of C. freundii were ESBL producing bacteria followed by E. coli (25%). It is thus paramount to address the burden of silently and speedily increasing infections caused by drug resistant strains of MRSA and ESBL in Nepal.
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Affiliation(s)
- Narbada Upreti
- 1Central Department of Microbiology, Tribhuvan University, Kirtipur, Nepal
| | - Binod Rayamajhee
- 2National College (Tribhuvan University), Khusibu, Kathmandu, Nepal.,Department of Infectious Diseases and Immunology, Kathmandu Research Institute for Biological Sciences (KRIBS), Lalitpur, Nepal
| | - Samendra P Sherchan
- 4Department of Global Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA USA
| | | | - Megha Raj Banjara
- 1Central Department of Microbiology, Tribhuvan University, Kirtipur, Nepal
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Binod G, Sapkota R, Rayamajhee B, Poudel P, Thapa S, Lekhak S, Khanal S. Detection of blaNDM-1 gene among the carbapenem resistant Escherichia coli and Klebsiella pneumoniae isolates. N Biotechnol 2018. [DOI: 10.1016/j.nbt.2018.05.1038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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G.C B, Sapkota NR, Rayamajhee B, Lamichhane J, Poudel P, Lekhak S, Thapa S, Khanal S. Detection of blaNDM-1 gene among the carbapenem resistant Escherichia coli and Klebsiella pneumoniae isolates from a children’s hospital in Nepal. Novel Research in Microbiology Journal 2018. [DOI: 10.21608/nrmj.2018.17862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Maharjan S, Rayamajhee B, Shreshtha A, Acharya J. Serotyping and antibiotic susceptibility patterns of Vibrio and Shigella isolates from diarrheal patients visiting a Tropical and Infectious Diseases Hospital in central Nepal. BMC Res Notes 2017; 10:626. [PMID: 29183395 PMCID: PMC5704626 DOI: 10.1186/s13104-017-2967-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 11/21/2017] [Indexed: 12/02/2022] Open
Abstract
Background Diarrheal diseases are the major infectious disease in developing countries like Nepal. Lack of proper sanitation and antimicrobial resistance gained by microbes have challenged to address diarrheal diseases in resource-limited countries. Early diagnosis of disease and proper antibiotic treatment can significantly reduce the disease burden. This study was designed to determine the recent antimicrobial susceptibility pattern of Vibrio cholerae and Shigella spp. to assure the proper antibiotic treatment. Stool specimens were processed following microbiological protocol and identified by biochemical and serological tests recommended by the Clinical Laboratory Standard Institute. Results Out of total 640 analyzed stool samples, 50 were culture positive, among them 29 were Shigella spp. (64.4%) and 21 were V. cholerae (46.6%). All V. cholerae strains belonged to the serogroup O1 and serovar Ogawa. Among the Shigella spp., Shigella flexneri 17 (59%) topped the list of serotype followed by Shigella sonnei 8 (28%), Shigella dysenteriae 3 (10%) and Shigella boydii 1 (3%) respectively. All the V. cholerae isolates (100%) were sensitive to cefotaxime while 71% were sensitive to tetracycline but 100 and 90.4% were resistance to co-trimoxazole and nalidixic acid respectively. Shigella isolates were mostly susceptible to cefotaxime (97%) while ciprofloxacin (48%) and ofloxacin (55%) were less effective drugs. Conclusions These results on the prevalence of enteropathogens and their antibiotic resistance pattern may help to guide accurate choice of therapy in clinical setting. Hence, development of evidence based National Guidelines for the treatment of diarrhea is needed. Electronic supplementary material The online version of this article (10.1186/s13104-017-2967-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sujan Maharjan
- St. Xavier's College (Tribhuvan University), Maitighar, Kathmandu, Nepal
| | - Binod Rayamajhee
- Kathmandu Research Institute for Biological Sciences (KRIBS), 19533, Lalitpur, Nepal. .,Department of Microbiology, National College (Tribhuvan University), Khusibu, Kathmandu, Nepal.
| | - Anima Shreshtha
- Tri-Chandra Multiple College (Tribhuvan University), Ghantaghar, Kathmandu, Nepal
| | - Jyoti Acharya
- National Public Health Laboratory, Government of Nepal, Ministry of Health Services, Teku, Kathmandu, Nepal
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