Changing Antimicrobial Resistance Trends in Kathmandu, Nepal: A 23-Year Retrospective Analysis of Bacteraemia
A comprehensive longitudinal understanding of the changing epidemiology of the agents causing bacteraemia and their AMR profiles in key locations is crucial for assessing the progression and magnitude of the global AMR crisis. We performed a retrospective analysis of routine microbiological data fro...
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Frontiers Media S.A.
2018-09-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fmed.2018.00262/full |
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| author | Raphaël M. Zellweger Buddha Basnyat Buddha Basnyat Buddha Basnyat Poojan Shrestha Krishna G. Prajapati Sabina Dongol Paban K. Sharma Samir Koirala Thomas C. Darton Thomas C. Darton Christine Boinett Corinne N. Thompson Guy E. Thwaites Guy E. Thwaites Stephen Baker Stephen Baker Stephen Baker Abhilasha Karkey Abhilasha Karkey Abhilasha Karkey |
| author_facet | Raphaël M. Zellweger Buddha Basnyat Buddha Basnyat Buddha Basnyat Poojan Shrestha Krishna G. Prajapati Sabina Dongol Paban K. Sharma Samir Koirala Thomas C. Darton Thomas C. Darton Christine Boinett Corinne N. Thompson Guy E. Thwaites Guy E. Thwaites Stephen Baker Stephen Baker Stephen Baker Abhilasha Karkey Abhilasha Karkey Abhilasha Karkey |
| author_sort | Raphaël M. Zellweger |
| collection | DOAJ |
| description | A comprehensive longitudinal understanding of the changing epidemiology of the agents causing bacteraemia and their AMR profiles in key locations is crucial for assessing the progression and magnitude of the global AMR crisis. We performed a retrospective analysis of routine microbiological data from April 1992 to December 2014, studying the time trends of non-Salmonella associated bacteraemia at a single Kathmandu healthcare facility. The distribution of aetiological agents, their antimicrobial susceptibility profiles, and the hospital ward of isolation were assessed. Two hundred twenty-four thousand seven hundred forty-one blood cultures were performed over the study period, of which, 30,353 (13.5%) exhibited growth for non-contaminant bacteria. We observed a significant increasing trend in the proportion of MDR non-Salmonella Enterobacteriaceae (p < 0.001), other Gram-negative organisms (p = 0.006), and Gram-positive organisms (p = 0.006) over time. Additionally, there was an annual increasing trend in the proportion of MDR organisms in bacteria-positive blood cultures originating from patients attending the emergency ward (p = 0.006) and the outpatient department (p = 0.006). This unique dataset demonstrates that community acquired non-Salmonella bacteraemia has become an increasingly important cause of hospital admission in Kathmandu. An increasing burden of bacteraemia associated with MDR organisms in the community underscores the need for preventing the circulation of MDR bacteria within the local population. |
| first_indexed | 2024-12-12T14:11:40Z |
| format | Article |
| id | doaj.art-3f433b0d80614690837b7f42274c801d |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-12-12T14:11:40Z |
| publishDate | 2018-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-3f433b0d80614690837b7f42274c801d2022-12-22T00:22:02ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2018-09-01510.3389/fmed.2018.00262388524Changing Antimicrobial Resistance Trends in Kathmandu, Nepal: A 23-Year Retrospective Analysis of BacteraemiaRaphaël M. Zellweger0Buddha Basnyat1Buddha Basnyat2Buddha Basnyat3Poojan Shrestha4Krishna G. Prajapati5Sabina Dongol6Paban K. Sharma7Samir Koirala8Thomas C. Darton9Thomas C. Darton10Christine Boinett11Corinne N. Thompson12Guy E. Thwaites13Guy E. Thwaites14Stephen Baker15Stephen Baker16Stephen Baker17Abhilasha Karkey18Abhilasha Karkey19Abhilasha Karkey20Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, The Hospital for Tropical Diseases, Ho Chi Minh City, VietnamOxford University Clinical Research Unit, Patan Academy of Health Sciences, Kathmandu, NepalCentre for Tropical Medicine and Global Health, Oxford University, Oxford, United KingdomGlobal Antibiotic Resistance Partnership, Centre for Disease Dynamics Economics and Policy, Washington, DC, United StatesOxford University Clinical Research Unit, Patan Academy of Health Sciences, Kathmandu, NepalPatan Academy of Health Sciences, Patan Hospital, Kathmandu, NepalOxford University Clinical Research Unit, Patan Academy of Health Sciences, Kathmandu, NepalPatan Academy of Health Sciences, Patan Hospital, Kathmandu, NepalOxford University Clinical Research Unit, Patan Academy of Health Sciences, Kathmandu, NepalWellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, The Hospital for Tropical Diseases, Ho Chi Minh City, VietnamSheffield teaching hospitals NHS trust foundation and the University of Sheffield, Sheffield, United KingdomWellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, The Hospital for Tropical Diseases, Ho Chi Minh City, VietnamWellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, The Hospital for Tropical Diseases, Ho Chi Minh City, VietnamWellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, The Hospital for Tropical Diseases, Ho Chi Minh City, VietnamCentre for Tropical Medicine and Global Health, Oxford University, Oxford, United KingdomWellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, The Hospital for Tropical Diseases, Ho Chi Minh City, VietnamCentre for Tropical Medicine and Global Health, Oxford University, Oxford, United KingdomThe Department of Medicine, University of Cambridge, Cambridge, United KingdomOxford University Clinical Research Unit, Patan Academy of Health Sciences, Kathmandu, NepalCentre for Tropical Medicine and Global Health, Oxford University, Oxford, United KingdomGlobal Antibiotic Resistance Partnership, Centre for Disease Dynamics Economics and Policy, Washington, DC, United StatesA comprehensive longitudinal understanding of the changing epidemiology of the agents causing bacteraemia and their AMR profiles in key locations is crucial for assessing the progression and magnitude of the global AMR crisis. We performed a retrospective analysis of routine microbiological data from April 1992 to December 2014, studying the time trends of non-Salmonella associated bacteraemia at a single Kathmandu healthcare facility. The distribution of aetiological agents, their antimicrobial susceptibility profiles, and the hospital ward of isolation were assessed. Two hundred twenty-four thousand seven hundred forty-one blood cultures were performed over the study period, of which, 30,353 (13.5%) exhibited growth for non-contaminant bacteria. We observed a significant increasing trend in the proportion of MDR non-Salmonella Enterobacteriaceae (p < 0.001), other Gram-negative organisms (p = 0.006), and Gram-positive organisms (p = 0.006) over time. Additionally, there was an annual increasing trend in the proportion of MDR organisms in bacteria-positive blood cultures originating from patients attending the emergency ward (p = 0.006) and the outpatient department (p = 0.006). This unique dataset demonstrates that community acquired non-Salmonella bacteraemia has become an increasingly important cause of hospital admission in Kathmandu. An increasing burden of bacteraemia associated with MDR organisms in the community underscores the need for preventing the circulation of MDR bacteria within the local population.https://www.frontiersin.org/article/10.3389/fmed.2018.00262/fullbloodstream infectionsbacteraemiablood culturesurveillancecommunity acquiredantimicrobial resistance |
| spellingShingle | Raphaël M. Zellweger Buddha Basnyat Buddha Basnyat Buddha Basnyat Poojan Shrestha Krishna G. Prajapati Sabina Dongol Paban K. Sharma Samir Koirala Thomas C. Darton Thomas C. Darton Christine Boinett Corinne N. Thompson Guy E. Thwaites Guy E. Thwaites Stephen Baker Stephen Baker Stephen Baker Abhilasha Karkey Abhilasha Karkey Abhilasha Karkey Changing Antimicrobial Resistance Trends in Kathmandu, Nepal: A 23-Year Retrospective Analysis of Bacteraemia Frontiers in Medicine bloodstream infections bacteraemia blood culture surveillance community acquired antimicrobial resistance |
| title | Changing Antimicrobial Resistance Trends in Kathmandu, Nepal: A 23-Year Retrospective Analysis of Bacteraemia |
| title_full | Changing Antimicrobial Resistance Trends in Kathmandu, Nepal: A 23-Year Retrospective Analysis of Bacteraemia |
| title_fullStr | Changing Antimicrobial Resistance Trends in Kathmandu, Nepal: A 23-Year Retrospective Analysis of Bacteraemia |
| title_full_unstemmed | Changing Antimicrobial Resistance Trends in Kathmandu, Nepal: A 23-Year Retrospective Analysis of Bacteraemia |
| title_short | Changing Antimicrobial Resistance Trends in Kathmandu, Nepal: A 23-Year Retrospective Analysis of Bacteraemia |
| title_sort | changing antimicrobial resistance trends in kathmandu nepal a 23 year retrospective analysis of bacteraemia |
| topic | bloodstream infections bacteraemia blood culture surveillance community acquired antimicrobial resistance |
| url | https://www.frontiersin.org/article/10.3389/fmed.2018.00262/full |
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