Biofilm formation capacity and Carbapenem-resistance in Acinetobacter-calcoaceticus-baumannii isolated from inpatients in a Tertiary Care Hospital in Nepal

Biofilm formation capacity and Carbapenem-resistance in Acinetobacter-calcoaceticus-baumannii isolated from inpatients in a Tertiary Care Hospital in Nepal

Shova Bhandari¹, Milan Kumar Upreti^1, Khadga Bikram Angbuhang¹, Basudha Shrestha², Upendra Thapa Shrestha^{3 *}

 ¹GoldenGate International College, Battisputali, Kathmandu Nepal

²Kathmandu Model Hospital, Kathmandu, Nepal

³Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal

 ^*Corresponding author: Upendra Thapa Shrestha, Assistant Professor, Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal, Email: upendrats@gmail.com / upendra.thapashrestha@cdmi.tu.edu.np

 ABSTRACT

Objective: Acinetobacter calcoaceticus-baumannii complex (ACBC), as an emerging global burden to various clinical infections, has a huge problem in empirical therapy due to the increasing resistance to the majority of antibiotics. The ability of biofilm formation added to its antimicrobial resistance and helped its persistence and survival in the environment. To associate biofilm formation with carbapenem resistance, a hospital-based cross-sectional study was carried out from February 2020 to August 2020 at Kathmandu Model Hospital, Kathmandu, Nepal. ACBC was identified from the clinical samples following standard Microbiological procedures. A modified Kirby-Bauer disk diffusion method was performed to assay the antibiotic susceptibility testing of ACBC isolates to various antibiotic classes. A quantitative adherence assay was used to determine the biofilm assay. A conventional Polymerase Chain Reaction (PCR) method was used to find the targeted biofilm-related genes, Bap, csuE, and bla_PER1 using specific primers.

 

Results: Out of 665 different clinical samples, bacterial growth was observed in 281 (42.3%) clinical samples. Of these, 32 (11.4%) isolates were identified as ACBC. Out of 32 ACBC isolates, 29 (90.6%) of which were carbapenem-resistant.  All carbapenem-resistant ACBC isolates were found to be sensitive to Polymixin B and Colistin. Out of 29 CR-ACBC, 17.2% of isolates were resistant to Tigecycline. The majority of ACBC isolates (93.8%) were multidrug-resistant (MDR) while 13 (40.6%) of isolates were extensively drug-resistant (XDR). A total of 31 ACBC isolates were biofilm producers, out of which 2 were strong biofilm producers followed by 8 moderate, and 21 were weak biofilm producers. The occurrence of biofilm-forming genes; Bap, csuE, and bla_PER1 genes were found to be 65.6%, 65.6%, and 56.3% respectively among ACBC clinical isolates. A significant association was observed between carbapenem resistance, biofilm formation, and biofilm-related genes.

Conclusion: The higher rate of MDR and XDR ACBC isolates associated with biofilm formation in the study alarms the ACBC-related infection in clinical settings among inpatients. The hospital environment and clinical equipment are potential sources of biofilm-forming isolates. Hence, the effective sterilization of clinical equipment and hospital environment are utmost and a strong policy should be made to prescribe the proper antibiotic based on antibiogram profile to fight against an emerging threat of ACBC infections.

Keywords: Acinetobacter baumannii, Biofilm, Carbapenem-resistant, Biofilm related genes; Bap, csuE, and bla_PER1

Citation: Bhandari, S., Upreti, M.K., Angbuhang, K.B. et al. Biofilm formation capacity and Carbapenem-resistance in Acinetobacter-calcoaceticus-baumannii isolated from inpatients in a tertiary care hospital in Nepal. BMC Res Notes 18, 225 (2025). 

DOI: https://doi.org/10.1186/s13104-025-07211-5

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Oral Presentation on International Conference-2024, Chitwan, Nepal

Interlinkage of β-Lactam Resistant Bacterial Genes from Clinical, Environmental, and Poultry Isolates from Kathmandu; A Big Threat of AMR

 

 

Vulvovaginal Candidiasis, an increasing burden to women in the tropical regions attending Bharatpur Hospital, Chitwan

Anisha Subedi^1#, Milan Kumar Upreti^1#, Jid Chani Rana², Ram Prasad Sapkota², Upendra Thapa Shrestha^{3 *}                                              

¹ Department of Microbiology, Goldengate International College, Battisputali, Kathmandu

² Bharatpur Hospital, Chitwan

³ Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu

^# These authors equally contributed to the study

^* Corresponding author: Upendra Thapa Shrestha, Assistant Professor, Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal. Email: upendrats@gmail.com

ABSTRACT

 

Vulvovaginal candidiasis is a yeast infection commonly caused by the overgrowth of Candida species in and around the vulva and vagina. Abnormal vaginal discharge, itching and irritation, swelling and redness of the vaginal area, pain during sexual intercourse, and dyspareunia are important clinical findings of the infection. Currently, the infection is one of the growing burdens to married women. Moreover, the infection with antifungal-resistant Candida species adds challenges to managing the disease. Hence, this study was conducted to identify the different Candida species causing vulvovaginal candidiasis and to determine its susceptibility pattern against different antifungal drugs. A hospital-based cross-sectional and quantitative study was conducted for the period of six months from September 2022 to March 2023 among symptomatic married women in the Gynecology and Obstetrics Department of Bharatpur Hospital, Chitwan. A total of 300 symptomatic cases were enrolled in the study. Candida species were isolated from vaginal swabs following standard microbiological procedures and antifungal susceptibility testing was performed with different antifungal agents. The total prevalence of vulvovaginal candidiasis was found to be 37.3% (112/300). Among different isolates, Candida albicans was found to be the most predominant (52.6%), followed by Candida glabrata (29.3%) among non-albicans. Women from the age group 25-35 years were found to be more infected (47.3%) and the relationship between contraceptive use and vulvovaginal candidiasis was found to be statistically significant (p<0.05). Candida species showed higher susceptibility toward Amphotericin-B (68.1%), followed by Fluconazole (51.7%), and Clotrimazole (50.9%). Whereas the least susceptibility was observed to Voriconazole (27.6%) and Itraconazole (35.30%). Candida albicans was comparatively more susceptible to different antifungal drugs than non-albicans species. Candida parapsilosis was only susceptible to Amphotericin-B and the increasing incidence of vaginal candidiasis due to non-albicans Candida indicates the need for routine speciation of Candida.

 

Keywords:    Vulvovaginal candidiasis, HiCrome agar, Candida albicans, Candida non-albicans Antifungal Susceptibility testing

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