G6PD deficiency among a particular group of people in Terai

Original Article

Population Based Survey of Glucose-6-Phosphate Dehydrogenase(G6PD) Deficiency among People Living in Terai Districts of Nepal

Niraj Lamichhane¹, Nabaraj Adhikari², Upendra Thapa Shrestha ², Komal Raj Rijal², Megha Raj Banjara², Prakash Ghimire^2*

¹ Department of Microbiology, Kantipur College of Medical Science, Sitapaila, Kathmandu

² Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu

*Corresponding Author: Dr. Prakash Ghimire; Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu; Email: prakash.ghimire@microbiotu.edu.np

ABSTRACT

Objective: This study was carried out to determine the prevalence of Glucose-6-phosphate dehydrogenase (G6PD) deficiency among population of selected malaria endemic districts in central and eastern terai of Nepal.

Methods: Six hundred seventy whole blood samples were collected from the indigenous peoples community, identified based on district public health office records for G6PDd in the past from   Jhapa, Morang and Dhanusha districts endemic to malaria, during April to June 2013. Collected blood samples were tested on the sites by using BinaxNow G6PD test kit and CareStart^TMG6PD test kits.

Results: The G6PD deficiency was found to be 6.1% and 6.3% in BinaxNow and CareStartTM respectively. In 42 G6PD deficient cases, male to female ration was almost equal. Higher proportions of deficient cases were from Rajbanshi and Santhal communities, than others. Highest number of deficient cases was in Jhapa followed by Morang and Dhanusha districts respectively.

Conclusion: G6PD deficiency in indigenous population groups in eastern and central terai are heterogenous, so testing of G6PD before initiation of radical treatment for P vivax infection would be important for reducing the risk of hemolysis following PQ administration, and rational evidence based PQ administration may be helpful in contributing towards elimination of malaria from the country.

Key words: G6PD, BinaxNow G6PD  and CareStart^TM G6PD

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For Citation: Lamichhane et al., 2017 TUJM Vol 4(1): 73-78

Article published in TUJM Volume 4(1)

Vancomycin Resistant Staphylococcus aureus Reported from Tertiary Care Hospital in Nepal

Urmila Lama¹, Dharmendra Shah², Upendra Thapa Shrestha^3*

¹ Department of Microbiology, Kantipur College of Medical Science, Sitapaila, Kathmandu

² Manmohan Memorial Medical College and Teaching Hospital, Swoyambhu, Kathmandu

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

*Corresponding address: Upendra Thapa Shrestha, Central Department of Microbiology, Tribhuvan University, Kirtipur Email: upendrats@gmail.com

ABSTRACT

Objectives: The study was conducted to assess the rate of Methicillin-resistant Staphylococcus aureus (MRSA) among patients and healthcare personnel at Manmohan Memorial College and Teaching Hospital, Kathmandu, Nepal and to evaluate the minimum inhibitory concentration of Vancomycin to MRSA isolates.

Methods: A total of 1433 different clinical specimens from patients and 33 nasal swabs from healthcare personnel were subjected to bacteriological investigation following standard protocol. S. aureus were isolated and identified by using standard Microbiological tools. Those isolates were subjected to Antimicrobial susceptibility testing using modified Kirby-Bauer’s disc diffusion method following CLSI guidelines.

Results: The rate of S. aureus carriage was found to be 65 (18.9%) in the samples from clinical patients and 24 (72.7%) in the samples from healthcare personnel. The rate of MRSA was found to be 57 (85.1%) in patients and 24 (100%) in healthcare personnel. The high distribution of MRSA was found in female of age group 21-30 years (patients: 10.4%; healthcare personnel: 70.8%). Amikacin was found to be most effective antimicrobial. All S. aureus isolates were found to be multidrug resistant (100%). On performing D-test, 10 (17.5%) and 22 (38.6%) of MRSA from clinical specimens showed inducible and constitutive Clindamycin resistance respectively. Whereas, 11 (45.8%) and 4 (16.7%) of MRSA from nasal swabs were found to be inducible and constitutive Clindamycin resistance respectively. Upon performing minimum inhibitory concentration (MIC) test for clinical isolates, 3.5% (2) of MRSA were found to be Vancomycin resistant (VRSA), 54.4% (31) were Vancomycin intermediate (VISA) and 42.1% (24) were found to be Vancomycin sensitive (VSSA). All of the nasal swab MRSA isolates were found sensitive to Vancomycin. Congo red agar method was done for biofilm production. For clinical isolates, 32 (47.8%) were found to be strong, 6 (8.9%) moderate and 29 (43.3%) were non biofilm producer. For nasal swab isolates, 66.7% (16) and 33.3% (8) were found as strong and non-biofilm producer respectively.

Conclusion: This study reported the case of VRSA which hasn’t been reported in Nepal. Though present study showed that Vancomycin remains the main choice of treatment of MRSA infection. Therefore, to preserve its value, use of vancomycin should be limited only to those cases where there are clearly needed.

Key words: S. aureus, MRSA, D-test, Inducible Clindamycin resistance, VRSA

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For Citation: Lama et al. 2017; TUJM 4(1): 63-72